Individual provider Active NPI

Celine Phong

  • Student in an Organized Health Care Education/Training Program
  • Temecula, CA
National Provider Identifier
1003502444
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone
(951) 600-4338
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

31700 Temecula Pkwy
Temecula, CA 92592-5896

Mailing address

31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone (951) 600-4338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250528000153 CA Order and Referring Only - DermatologyPractitioner - Dermatology 2264951854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1003502444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 TEMECULA PKWY",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925896",
            "telephone_number": "951-600-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31700 TEMECULA PKWY",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925896",
            "telephone_number": "951-600-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHONG",
        "first_name": "CELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.