Jacqueline Vannga Phan, D.C., L.AC.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC27147 Issued in CA

Practice address

1250 N Euclid St
Anaheim, CA 92801-1966

Phone

(714) 991-1810

NPI assigned

Jan 24, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nhanhau Ngo MD Inc

  • Family Medicine Physician
  • Westminster, CA
  • NPI 1164455226
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1043365612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011966",
            "telephone_number": "714-991-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011966",
            "telephone_number": "714-991-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "JACQUELINE",
        "middle_name": "VANNGA",
        "name_prefix": "Dr.",
        "credential": "D.C., L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Khai Phan
• Bryan Loc Phan
• Derrick Phan
• Diem Huong Thi Phan
• Dylan Phan
• Minh Phan
• Paul Phan, PHARM D
• Phung Ngoc Phan
• Samuel Khoa Phan, ASW
• Vu T Phan, NP

• Chiropractor in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.