AIVI DOLAN PHUNG (NPI# 1639528110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639528110 |
| Entity Type | Individual |
| Full Name | AIVI DOLAN PHUNG |
| Credential | PA-C |
| Practice Address |
6973 Linda Vista Rd San Diego CA 92111-6342 |
| Practice Telephone | 8582790925 |
| Mailing Telephone | 8582790925 |
| Mailing Fax Number | 8586334680 |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2020-09-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA53902 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5575 Ruffin Rd Ste 100, San Diego, CA 921231361 | 8582772744 |
| Street Address |
6973 LINDA VISTA RD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92111-6342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487640686 | Judy Lynn Dye | Nurse Practitioner | 6973 Linda Vista Rd, San Diego, CA 92111-6339 | 2005-09-22 |
| 1568027670 | Van Ai Vo | Dental Hygienist | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2019-05-03 |
| 1437630787 | Lauren Rose Spinelli | Social Worker | 6973 Linda Vista Rd, San Diego, CA 92111 | 2018-08-24 |
| 1124524186 | Hilary Sibilia | Nurse Practitioner | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2018-03-30 |
| 1528595543 | Emily Bruno | Preventive Medicine | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2017-05-22 |
| 1831626837 | Shelly Jean Marion Smith | Nurse Practitioner | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2017-05-22 |
| 1215489166 | Brandon Binh-yen Le | Chiropractor | 6973 Linda Vista Rd, San Diego, CA 92111 | 2016-10-26 |
| 1902350994 | Chi Quynh Hoang | Nurse Practitioner | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2016-08-08 |
| 1952785784 | Lauren Woolley | Psychologist | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2015-07-10 |
| 1518355445 | Lesley Ivy Dorfman | Psychologist | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2014-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220653 | Karen Elizabeth Mitchell | Registered Nurse | County of San Diego California Children's Services (ccs, 6991 Balboa Ave, (room 70), San Diego, CA 92111 | 2020-06-18 |
| 1912523804 | Access Medical, Inc. | Durable Medical Equipment & Medical Supplies | 4150 Convoy Street, Suite A, San Diego, CA 92111 | 2020-06-17 |
| 1154944551 | Mei Ling Milan Szeto | Student in an Organized Health Care Education/Training Program | 7917 Ostrow Street, Suite A, San Diego, CA 92111 | 2020-05-20 |
| 1346893831 | Leticia Isabel Peralta | Assistant Behavior Analyst | 563 Balboa Avenue. Number 521, San Diego, CA 92111 | 2019-07-23 |
| 1295204394 | Demetria Serfas | Behavioral Analyst | 563 Balboa Ave #521, San Diego, CA 92111 | 2018-11-19 |
| 1568981678 | Ross Psychology | Psychologist | 4883 Ronson Court, Suite K, San Diego, CA 92111 | 2017-09-11 |
| 1225554587 | Bianca Acosta | Technician, Other | 563 Balboa Ave. #521, San Diego, CA 92111 | 2017-08-18 |
| 1194240085 | Kazuhiro Kato | Dentist | 3707 Convoy St., San Diego, CA 92111 | 2017-08-11 |
| 1073038527 | Joanne Epps-yentz | Licensed Vocational Nurse | 7414 Mesa College Dr. Apt 47, San Diego, CA 92111 | 2017-08-06 |
| 1184158446 | Positive Behavior Supports Corp | Community/Behavioral Health | 563 Balboa Ave, 521, San Diego, CA 92111 | 2017-04-13 |
| Find all providers in zip 92111 | ||||
| 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 |
|---|---|---|---|---|
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| 1639776503 | Nathan Tuan Dinh | Physician Assistant | 8296 Via Escalada, San Diego, CA 92129-2223 | 2020-10-05 |
| 1750988671 | Denise Aquino | Physician Assistant | 7322 Mesa College Dr Apt 7, San Diego, CA 92111-4943 | 2020-10-04 |
| 1962009183 | Courtney Krysl | Physician Assistant | 14434 Corte Lampara, San Diego, CA 92129-3818 | 2020-10-01 |
| 1497369284 | Brian Carroll | Physician Assistant | 7242 Melotte St, San Diego, CA 92119-1613 | 2020-08-31 |
| 1871104067 | Satoshi Ikeda | Physician Assistant | 16198 Paseo Del Sur, San Diego, CA 92127-6155 | 2020-08-12 |
| 1760009989 | Lili Tran | Physician Assistant | 8865 Calle Tragar, San Diego, CA 92129-2156 | 2020-07-03 |
| 1245857259 | Kendra Roberta Witt | Physician Assistant | 11396 Poblado Rd, San Diego, CA 92127-1351 | 2020-06-25 |
| 1336766344 | Brandon Scott Johnson | Physician Assistant | 1540 Oliver Ave Apt C, San Diego, CA 92109-5595 | 2020-06-25 |
| 1104441021 | Kira Ann Tellache | Physician Assistant | 4520 Executive Dr Ste 325, San Diego, CA 92121-3087 | 2020-06-16 |
| Find all providers in SAN DIEGO | ||||
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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.