Organization
INTERNATIONAL PEDIATRIC MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AN TAN PHAM MD (MD)
(510) 208-3540
Entity
Organization
Contact information
Practice address
600 INTERNATIONAL BLVD, #102, OAKLAND, CA 94606
(510) 208-3540
(510) 208-3553
Mailing address
600 INTERNATIONAL BLVD, #102, OAKLAND, CA 94606
(510) 208-3540
(510) 208-3553
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A67904
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A679040
MEDI CAL
CA
Enumeration date
09/21/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up