Mindy Thanh Phan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA56216 Issued in CA

Practice address

661 W 1St St Ste G
Tustin, CA 92780-2939

Phone

(714) 665-9890

Fax

(714) 665-9891

NPI assigned

Sep 17, 2018

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mindy.phan.p4@direct.scpeds.nextgenshare.com

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.

• Families Together of Orange County

  • Clinic/Center
  • Tustin, CA
  • NPI 1194122457
  Medicare reassignment
• Families Together of Orange County

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1861253080
  NPD
• Anhthu Ngoc Nguyen MD Inc

  • Physical Medicine & Rehabilitation Physician
  • Garden Grove, CA
  • NPI 1003279480
  NPD (past)
• Families Together of Orange County

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1114788239
  NPD (past)
• Timothy Thien Tran MD Inc

  • Family Medicine Physician
  • Garden Grove, CA
  • NPI 1699129916
  NPD (past)

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1063996916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11180 Warner Ave Ste 353",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087516",
            "country_code": "US",
            "telephone_number": "714-968-6789",
            "fax_number": "714-202-2626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9918 Katella Ave Ste A-C",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046465",
            "country_code": "US",
            "telephone_number": "714-644-9494",
            "fax_number": "714-644-9894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "MINDY",
        "middle_name": "THANH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• My Nguyen Pham
• Allyson Tram Phan, FNP
• Eunice Jill Canonizado Phan, MSN, FNP-BC, FNP-C
• Kathy Phan
• Matt Phan, D.M.D.
• Alyssa Phillips, AMFT
• Clifford M Phipps, DDS
• Andy Phung, OTR/L
• Jessica Phung, DPT
• Thanh Gia Phung, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.