Kim Phan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4980 Barranca Pkwy Ste 202
Irvine, CA 92604-8653

Phone

(949) 733-1336

NPI assigned

Sep 27, 2022

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kim Tang MD IncGroup PAC ID 0749699080, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Kim Tang, M.D., Inc.

  • MOHS-Micrographic Surgery Physician
  • Lake Forest, CA
  • NPI 1396339255
  Medicare reassignment Care Compare group
• Ira Bell

  • Dermatology Physician
  • Lake Forest, CA
  • NPI 1891978714
  NPD

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1043934706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 S WOODLAND PL",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927074737",
            "telephone_number": "714-791-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 BARRANCA PKWY STE 202",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926048653",
            "telephone_number": "949-733-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KIM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tu Pham
• Tuyen Thien Pham, PHARMD
• Anne Phan-Huy, MD
• Andrew Phan, MSPAS
• Cattien Ngoc Phan, DO
• Kimberly Sue Phan, D.O
• Maggie Ngan Phan, PHARM D.
• Michael Phan, PHARM.D.
• Nathan Phan
• Phuoc Huu Phan, DDS

• Physician Assistant in Irvine, CA
• Providers in Irvine, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.