MR. PHILIP FAGAN III (NPI# 1235634940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235634940 |
| Entity Type | Individual |
| Full Name | MR. PHILIP FAGAN III |
| Credential | MD |
| Practice Address |
2075 San Joaquin Hills Rd Newport Beach CA 92660-6505 |
| Mailing Address |
Naval Medical Center San Diego 38400 Bob Wilson Dr San Diego CA 92134-5000 |
| Practice Telephone | 9497609222 |
| Practice Fax Number | 9495792906 |
| Mailing Telephone | 4129519701 |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2019-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | A163621 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 921345000 | 4129519701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255335154 | Philip J. Fagan Jr. | Emergency Medicine | 14642 Newport Ave Ste 101, Tustin, CA 92780-6058 | 2005-06-08 |
| Street Address |
2075 SAN JOAQUIN HILLS RD |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-6505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821043357 | Newport Walk In Medical Group, Inc. | Clinic/Center | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2006-05-23 |
| 1174080030 | Brian Jeffry Jackson | Nurse Practitioner | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2019-02-27 |
| 1245705086 | Ryan Duy Pham | Physician Assistant | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2018-10-08 |
| 1811470925 | Courtney Galle | Nurse Practitioner | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2018-09-13 |
| 1568951440 | Luz Daniela Acevedo | Physician Assistant | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660 | 2018-05-06 |
| 1669725271 | Erin Elizabeth Wood | Physician Assistant | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660 | 2012-10-19 |
| 1538466107 | Marque Medical Clinic, Inc. | Family Medicine | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2011-02-17 |
| 1235265844 | Nathan Aron Kiskila | Family Medicine | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2007-02-26 |
| 1700911484 | Alison Sims M.d., Inc. | Clinic/Center | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2007-02-22 |
| 1407981285 | Alison F Sims | Internal Medicine | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2007-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1205445798 | Felecia A Pedrogo | Marriage & Family Therapist | 5020 Campus Street, Newport Beach, CA 92660 | 2020-07-30 |
| 1649898388 | Polyviou Dental Corportation, Inc. | Clinic/Center | 120 Newport Beach Drive, Suite 27, Newport Beach, CA 92660 | 2020-07-09 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144584970 | Rudolph C Baldoni | General Practice | 79 Linda Isle, Newport Beach, CA 92660-7208 | 2012-06-26 |
| 1821354804 | Marc L Paulsen | General Practice | 7134 Residencia, Newport Beach, CA 92660-9054 | 2012-04-04 |
| 1275778953 | Janine Gail Suvak | General Practice | 620 Newport Center Dr Ste 1100, Newport Beach, CA 92660-8011 | 2008-12-09 |
| 1609063163 | Roger Michael Farel | General Practice | 2201 Arbutus St, Newport Beach, CA 92660-4139 | 2007-09-28 |
| 1215948948 | John G Miller Md | General Practice | 355 Placentia Ave. Suite 103, Newport Beach, CA 92663 | 2006-08-10 |
| 1467096644 | Newport Surgery Center, LLC | General Practice | 400 Newport Center Dr Ste 102, Newport Beach, CA 92660-8602 | 2019-10-31 |
| 1568848802 | Jennifer Alice Armstrong | General Practice | 369 San Miguel Dr Ste 235, Newport Beach, CA 92660-7816 | 2015-08-10 |
| 1538544325 | Pk Medical Group Inc | General Practice | 2549 Eastbluff Dr Ste B, Newport Beach, CA 92660-3599 | 2015-07-22 |
| 1932536927 | Melvin I Marks | General Practice | 1501 Superior Ave, Suite #111 & 311, Newport Beach, CA 92663-3600 | 2013-10-04 |
| 1184057291 | Michael Ross Land | General Practice | 1000 Bristol St N, Ste 1b, Newport Beach, CA 92660-8916 | 2013-08-12 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
Please comment or provide details below to improve the information on MR. PHILIP FAGAN III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.