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

Ryan Pham, MD

Individual provider Internal Medicine Physician · NPI 1154980829

Ryan Pham, MD is an Internal Medicine in Boise, Idaho. Qualified in 2019, 7 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California and Idaho.

Years since qualifying
7
Licensed in
CA, ID
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-5015
Fax: (208) 381-1873
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1260 15th St, Santa Monica, CA 90404-1135 — (310) 656-1701
  • 1260 15th St Ste 1501, Santa Monica, CA 90404-1150 — (310) 656-1701

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence A178169 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 8261674 (ID)

Record details

NPI number1154980829
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 6, 2019
Last updated in NPPESNovember 8, 2024
Certification dateNovember 8, 2024
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Boise