Corey Pham
Dentist in San Ramon, CA. Individual provider (NPI-1).
NPI number1972989697
StatusActive
Last updated in NPPESAug 4, 2015
Details
- NPI
- 1972989697
- Entity type
- Individual (NPI-1)
- Name
- Corey Pham
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 4, 2015
- Last updated
- Aug 4, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - DENTIST
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 64877 | CA | Yes |
Practice location
3276 Casa Grande DrSan Ramon, CA 94583-3004
Phone 916-276-2503
Mailing address
3276 Casa Grande DrSan Ramon, CA 94583-3004
Phone 916-276-2503
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 65 Dentist providers in San Ramon · All 2,749 providers in San Ramon
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