Individual ProviderDuc Quy PhamInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address26800 Crown Valley Pkwy, Suite 315, Mission Viejo, CA 92691-6384(949) 364-6000(949) 282-1600PECOS EnrollmentThis provider is enrolled in PECOS as DUC PHAM.Based on the most recent information from CMS, provider Duc Quy Pham is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1689615221Provider TypeIndividualFull NamePham, Duc QuyTitleMr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date6/8/2006Last Updated11/9/2021Contact InformationPractice LocationPractice Address26800 Crown Valley Pkwy, Suite 315, Mission Viejo, CA 92691-6384Phone(949) 364-6000Fax(949) 364-1204Mailing LocationMailing Address26522 La Alameda, Suite 120, Mission Viejo, CA 92691-6330Phone(949) 282-1600Fax(949) 367-0518Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA62320CaliforniaProvider IdentifiersIDDescriptionIssuerID00A623200DescriptionMedicaidIssuerUnlistedCaliforniaIDGR0094890DescriptionMedicaidIssuerUnlistedCalifornia