DR. JASON THAI PHAN (NPI# 1619109303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619109303 |
| Entity Type | Individual |
| Full Name | DR. JASON THAI PHAN |
| Credential | D.D.S |
| Practice Address |
23451 Madison St Ste 210 Torrance CA 90505-4763 |
| Practice Telephone | 3103788342 |
| Practice Fax Number | 3103784672 |
| Mailing Telephone | 3103788342 |
| Mailing Fax Number | 3103784672 |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2016-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
58635 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972054666 | Jason Phan | Naturopath | 3454 Castle Glen Dr, #226, San Diego, CA 92123-2443 | 2016-10-18 |
| 1093229338 | Jason Phan | Nurse Practitioner | 22224 La Palma Ave Ste A, Yorba Linda, CA 92887-3819 | 2017-11-23 |
| Street Address |
23451 MADISON ST STE 210 |
| City | TORRANCE |
| State | CA |
| Zip Code | 90505-4763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043213242 | Carl Wagreich | Podiatrist | 23451 Madison St, Ste 230, Torrance, CA 90505-4761 | 2005-05-23 |
| 1174981195 | Jason Phan Dds Inc. | Dentist | 23451 Madison St, Ste 210, Torrance, CA 90505-4763 | 2016-02-04 |
| 1992199277 | Rose Vargas | Nurse Practitioner | 23451 Madison St, Suite 340, Torrance, CA 90505-4763 | 2015-03-24 |
| 1538552252 | Peter Sinclair | Dentist | 23451 Madison St, Suite 130, Torrance, CA 90505-4763 | 2015-03-05 |
| 1245629666 | Peter M Sinclair, Dds A Professional Dental Corpor | Dentist | 23451 Madison St, Suite 130, Torrance, CA 90505-4763 | 2015-01-22 |
| 1972939007 | Lorraine Rojas | Physician Assistant | 23451 Madison St, Ste 340, Torrance, CA 90505-4762 | 2013-09-20 |
| 1477849982 | Eliza Lim Cambay | Nurse Practitioner | 23451 Madison St, Suite 290, Torrance, CA 90505-4763 | 2011-06-22 |
| 1013246909 | Bliss Medical Group, P.C. | Family Medicine | 23451 Madison St, Suite 250, Torrance, CA 90505-4763 | 2009-12-23 |
| 1063659829 | Janelle Robles Macasieb | Physician Assistant | 23451 Madison St, Suite 290, Torrance, CA 90505-4763 | 2009-01-15 |
| 1326206848 | Son X Nguyen | Surgery | 23451 Madison St, Suite 340, Torrance, CA 90505-4763 | 2008-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780229260 | Sleep Apnea Team LLC | Clinic/Center | 2785 Pacific Coast Hwy Ste. E #197, Torrance, CA 90505 | 2019-11-08 |
| 1811469349 | Laura Anne Bloomberg | Marriage & Family Therapist | 2790 Sky Park Drive, Suite 215, Torrance, CA 90505 | 2018-12-21 |
| 1629544234 | Doroty O.d.s. Devalon | Physician Assistant | 23530 Hawthorne Boulevard Building 1, Suite 290, Torrance, CA 90505 | 2018-10-22 |
| 1790270486 | Juste Karvelyte | Dentist | 3500 Lomita Blvd Ste 201, Torrance, CA 90505 | 2018-06-26 |
| 1023507324 | Robert De Leon | Physician Assistant | 23530 Hawthorne Blvd Ste 290, Torrance, CA 90505 | 2018-05-02 |
| 1376052274 | Regents of The University of California | Durable Medical Equipment & Medical Supplies | 3500 Lomita Bvld, Suite 300, Torrance, CA 90505 | 2017-09-22 |
| 1649796038 | Chan & Huang Dental Partnership | Dentist | 3640 Lomita Blvd., #208, Torrance, CA 90505 | 2017-08-17 |
| 1093238370 | Family Acupuncture, Inc. | Specialist/Technologist, Other | 2820 Sepulveda Blvd.ste.a, Torrance, CA 90505 | 2017-07-19 |
| 1629518535 | J Lee Acupuncture | Acupuncturist | 24248 Crenshaw Blvd. #106, Torrance, CA 90505 | 2017-02-27 |
| 1770932360 | Maha Hanna Dds Inc | Dentist | 3710 Pacific Coast Hwy, Ste 101, Torrance, CA 90505 | 2016-06-06 |
| Find all providers in zip 90505 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225435035 | David W Kelliny | Dentist | 22920 Crenshaw Blvd Ste A, Torrance, CA 90505-3023 | 2014-11-21 |
| 1821264664 | Fred Shoji Tsutsui | Dentist | 3640 Lomita Blvd Ste 304, Torrance, CA 90505-3957 | 2008-05-01 |
| 1598979387 | Sharon Michyko Kyomen | Dentist | 3290 Sepulveda Blvd, Torrance, CA 90505 | 2007-05-10 |
| 1194939991 | Todd Nakata, Dds Inc | Dentist | 3290 Sepulvoda Blvd, Torrance, CA 90505 | 2007-05-10 |
| 1346361854 | Ray Kuwahara,d.d.s.,inc | Dentist | 3655 Lomita Blvd Ste 217, Torrance, CA 90505-3958 | 2007-04-02 |
| 1194869743 | David Sung Kim | Dentist | 21229 Hawthorne Blvd, Suite A, Torrance, CA 90503-5501 | 2007-02-16 |
| 1790891935 | Erik E. Singer | Dentist | 3440 Torrance Blvd, Suite 102, Torrance, CA 90503-5805 | 2006-08-21 |
| 1588654073 | David W. Kelliny, Dds, Inc. | Dentist | 22920 Crenshaw Blvd, Suite A, Torrance, CA 90505-3023 | 2005-10-25 |
| 1700244746 | Mark Nugent | Dentist | 3663 Torrance Blvd Ste 3, Torrance, CA 90503-4817 | 2016-02-05 |
| 1174981195 | Jason Phan Dds Inc. | Dentist | 23451 Madison St, Ste 210, Torrance, CA 90505-4763 | 2016-02-04 |
| Find all providers in TORRANCE | ||||
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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.