Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim Ngan Pham

Individual provider Physician Assistant · NPI 1265115406

Kim Ngan Pham is a Physician Assistant in Tustin, California. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2023
Specialties on file
3
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Practice location Address checks out

13522 Newport Ave Ste 102
Tustin, CA 92780-3707
Phone: (714) 987-1121
Fax: (551) 236-2481
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1265115406 (CA)
Physician Assistant Taxonomy 363A00000X · Licence MP0684921 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 67708 (CA)

Record details

NPI number1265115406
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 14, 2023
Last updated in NPPESJuly 18, 2026
Certification dateJuly 18, 2026
Mailing address13522 Newport Ave Ste 102, Tustin, CA 92780-3707

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Tustin