Active NPI
Trevor Phan MD PC
- Hospitalist Physician
- Fallon, NV
National Provider Identifier
1033418892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 12765
- Legal business name
- TREVOR PHAN MD PC
- Practice address
- 801 E Williams Ave
Fallon, NV 89406-3052 - Phone
- (775) 530-5886
- Fax
- (702) 453-5741
- NPI assigned
- Mar 19, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Trevor Phan, MD
- Title
- Owner
- Phone
- (775) 530-5886
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 12765 | NV | Primary |
Addresses
Primary practice location
801 E Williams Ave
Fallon, NV 89406-3052
Mailing address
PO Box 17976
Reno, NV 89511-1034
Phone (775) 530-5886
Other practice location 1
520 N 4th Ave
Pasco, WA 99301-5257
Phone (775) 530-5886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12765 | Other | NV | MEDICAL LIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV, CA, WA, CO
Enrollment records 4
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300492800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675123200000",
"number": "1033418892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 17976",
"city": "RENO",
"state": "NV",
"postal_code": "895111034",
"telephone_number": "775-530-5886",
"fax_number": "702-453-5741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 E WILLIAMS AVE",
"city": "FALLON",
"state": "NV",
"postal_code": "894063052",
"telephone_number": "775-530-5886",
"fax_number": "702-453-5741"
}
],
"practiceLocations": [
{
"address_1": "520 N 4th Ave",
"address_purpose": "LOCATION",
"city": "Pasco",
"state": "WA",
"postal_code": "993015257",
"country_code": "US",
"telephone_number": "775-530-5886",
"fax_number": "702-453-5741",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "TREVOR PHAN MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-19",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A",
"authorized_official_last_name": "PHAN",
"authorized_official_first_name": "TREVOR",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "775-530-5886",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Hospitalist",
"state": "NV",
"license": "12765",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LIC",
"identifier": "12765",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fallon, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.