TUNG PHAN (NPI# 1508130311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508130311 |
| Entity Type | Individual |
| Full Name | TUNG PHAN |
| Credential | P.A. |
| Practice Address |
507 S Atlantic Blvd Los Angeles CA 90022-2621 |
| Mailing Address |
3125 W Anacapa Way Anaheim CA 92801-6154 |
| Practice Telephone | 3232689191 |
| Practice Fax Number | 3232689119 |
| Mailing Telephone | 8183179291 |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2017-10-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA22075 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699271429 | Tung Phan | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2018-04-02 |
| 1699848861 | Tung Thanh Phan | General Practice | 10152 Westminster Ave, Garden Grove, CA 92843-4754 | 2006-11-16 |
| Street Address |
507 S ATLANTIC BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90022-2621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508993460 | Dora Magana | Nurse Practitioner | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2007-02-27 |
| 1619433562 | Madona Yousef | Dental Hygienist | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2019-02-15 |
| 1902381452 | Susana Magana | Dental Hygienist | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2018-10-01 |
| 1811422652 | Victoria Marisol Moreno | Registered Nurse | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2017-05-01 |
| 1376998252 | Joanna Calderon-sandoval | Pediatrics | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2016-04-28 |
| 1275902967 | Viviana Partida | Nurse Practitioner | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2015-09-23 |
| 1225477672 | Bienvenidos Community Health Center Mobile Clinic | Clinic/Center | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2013-06-19 |
| 1497001226 | Via Care Community Health Center | Clinic/Center | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2012-07-30 |
| 1386883379 | Bienvenidos Children's Center | Case Management | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2009-02-13 |
| 1154573335 | Bienvenidos Children's Center, Inc. | Clinic/Center | 507 S Atlantic Blvd, Los Angeles, CA 90022-2621 | 2008-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1033699426 | Reachwell Home Health Inc | Home Health | 236 1/4 S Atlantic Blvd, Los Angeles, CA 90022 | 2018-08-15 |
| 1326528704 | Shelli Hernandez | Community Health Worker | Enki Health & Research Systems Inc., 1000 Goodrich Blvd., Commerce, CA 90022 | 2018-08-15 |
| 1477071660 | East Los Angeles Womens Center | Counselor | 1431 S. Atlantic Blvd, Los Angeles, CA 90022 | 2017-09-07 |
| 1467974824 | Ena Vilma Hernandez | Registered Nurse | 245 S Fetterly St, Los Angeles, CA 90022 | 2017-07-07 |
| 1437688843 | Maud D Legaspi | Social Worker | 5425 E. Pomona Blvd, Los Angeles, CA 90022 | 2017-06-08 |
| 1548793920 | Harbor Chiropractic, Inc., A Bahan Company | Chiropractor | 5301 Whittier Blvd, Atrium Lower Level, Los Angeles, CA 90022 | 2017-04-04 |
| 1326590423 | Via Care Community Health Center | Clinic/Center | 501 S. Woods Ave, Los Angeles, CA 90022 | 2016-10-25 |
| 1780057950 | Monica Poomiwatracanont | Pharmacist | 5176 E. Whittier Blvd., Los Angeles, CA 90022 | 2015-11-10 |
| 1609277433 | Ethan C. A Lee Dental Inc. | Dentist | 6046 Whittier Blvd., Los Angeles, CA 90022 | 2014-09-11 |
| Find all providers in zip 90022 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929644 | Tatum Little | Physician Assistant | 3307 W 79th St, Los Angeles, CA 90043-5249 | 2020-10-15 |
| 1144828963 | Chan Ho Park | Physician Assistant | 4721 Oakwood Ave, Los Angeles, CA 90004-3112 | 2020-10-14 |
| 1235737172 | Jennifer Rae Levitt Physician Assistant, Inc | Physician Assistant | 1439 N Highland Ave Ste 1059, Los Angeles, CA 90028-7622 | 2020-10-13 |
| 1174120943 | Melody Fatehi | Physician Assistant | 6228 Orange St Apt 9, Los Angeles, CA 90048-4836 | 2020-10-05 |
| 1467063826 | Hannah Shannon Rihani | Physician Assistant | 1737 Midvale Ave, Los Angeles, CA 90024-5512 | 2020-08-11 |
| 1356969901 | Emily Rachel Lavi | Physician Assistant | 1132 S Holt Ave Apt 7, Los Angeles, CA 90035-2424 | 2020-07-09 |
| 1083242952 | Julia Andrea Hurtado | Physician Assistant | 3783 Cimarron St, Los Angeles, CA 90018-4463 | 2020-03-27 |
| 1174150130 | Susan C. Williams | Physician Assistant | 2215 Alcazar St, Los Angeles, CA 90033-1003 | 2020-03-26 |
| 1720615776 | Shannon Hakakeyan | Physician Assistant | 1580 Manning Ave Apt 303, Los Angeles, CA 90024-6086 | 2020-03-26 |
| 1952938243 | Jayanti Sharma | Physician Assistant | 1515 Amherst Ave Apt 303, Los Angeles, CA 90025-3677 | 2020-03-25 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90022 |
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| 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.