Dung Ngoc Phan, R.PH.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RPH47041 Issued in CA

Practice address

4776 El Cajon Blvd
Ste 105
San Diego, CA 92115-4521

Phone

(619) 287-1206

NPI assigned

Jun 20, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

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.

• Dawn Pharmacy

  • Community/Retail Pharmacy
  • San Diego, CA
  • NPI 1053378760
  NPD (past)
• Dawn Pharmacy

  • Community/Retail Pharmacy
  • San Diego, CA
  • NPI 1063396026
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1073518627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4776 EL CAJON BLVD",
            "address_2": "STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154521",
            "telephone_number": "619-287-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4776 EL CAJON BLVD",
            "address_2": "STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154521",
            "telephone_number": "619-287-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "DUNG",
        "middle_name": "NGOC",
        "name_prefix": "Miss",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 47041",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "RPH47041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA435300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corrine Thanh Ngoc Phan, LCSW
• Diana Elizabeth Phan, ND
• Diana Thao Phan, SCM
• Diane Vu Phan, PT, DPT
• Diann Thuy Duong Phan, RN
• Helena Phan
• Hy Phan, M.D.
• Jacklynne Phan
• Jason Phan, ND
• Jennifer Phan, FNP

• Community/Retail Pharmacy in San Diego, CA
• Providers in San Diego, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.