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

Quantin Thien Pham, PA

Individual provider Medical Physician Assistant · NPI 1053082750

Quantin Thien Pham, PA is a Physician Assistant in Fullerton, California. Qualified in 2021, 5 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone: (714) 734-3120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 631 S Brookhurst St Ste 101, Anaheim, CA 92804-3563 — (714) 991-5700

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 62320 (CA)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1053082750
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 22, 2021
Last updated in NPPESApril 29, 2025
Certification dateApril 29, 2025
Mailing address100 E Valencia Mesa Dr Ste 310, Fullerton, CA 92835-3800

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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