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

Kyle Pham, PT, DPT

Individual provider Physical Therapist · NPI 1972262558

Kyle Pham, PT, DPT is a Physical Therapist in Private Practice in Elk Grove, California. Qualified in 2021, 5 years ago. Practices with Stac Physical Therapy Laguna Inc, a 5-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

9563 Laguna Springs Dr Ste 200
Elk Grove, CA 95758-8205
Phone: (916) 691-9822
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT301453 (CA)

Record details

NPI number1972262558
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorYes
NPI enumeratedDecember 10, 2021
Last updated in NPPESMay 24, 2024
Certification dateMay 24, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Stac Physical Therapy Laguna Inc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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