Carolyn Chu Phan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

301103 Issued in CA

Practice address

14120 Beach Blvd Ste 225
Westminster, CA 92683-4497

Phone

(866) 303-9355

NPI assigned

Oct 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Back2 Health Physical Therapy IncGroup PAC ID 8527068246, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Back2 Health Physical Therapy Inc

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
  • NPI 1053419408

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Advanced Joint and Spine Medical Center Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Orange, CA
  • NPI 1962930628
  Medicare reassignment NPD
• Evolution Physical Therapy, Inc

  • Physical Therapist
  • Culver City, CA
  • NPI 1174601116
  Medicare reassignment NPD
• Superior Joint and Spine Medical Center Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Westminster, CA
  • NPI 1679093728
  Medicare reassignment NPD
• April Lopez Chiropractic. a Professional Corporation

  • Rehabilitation Chiropractor
  • Orange, CA
  • NPI 1255452835
  NPD (past)
• Next Phase Medical PC

  • General Practice Physician
  • Culver City, CA
  • NPI 1821961863
  NPD (past)

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1023770146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11582 ELIZABETH ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928401632",
            "telephone_number": "714-782-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14120 BEACH BLVD STE 225",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834497",
            "telephone_number": "866-303-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "CAROLYN",
        "middle_name": "CHU",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carolynp@ocwellness.net",
            "affiliation": "Y",
            "endpointDescription": "work email address",
            "affiliationName": "Superior Joint and Spine, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "carolyncphan@gmail.com",
            "address_1": "14120 Beach Blvd Ste 225",
            "city": "Westminster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926834497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thuy-Vy DO Pham, FNP
• To Uyen Thi Pham, DDS
• Tran Lan Pham, DDS
• Trung Ngoc Pham, M.D.
• Vivian Pham
• Christine Phan
• Derek T Phan, M.D.
• Henry Quoc Phan
• Hoa Thi Xuan Phan, MD
• Huy Quoc Phan

• Physical Therapist in Westminster, CA
• Providers in Westminster, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.