Kim Phan DO PC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

KIM PHAN DO PC

Practice address

1180 N Indian Canyon Dr Ste E218
Palm Springs, CA 92262-4885

Phone

(760) 416-4800

Fax

(760) 416-4903

NPI assigned

Oct 7, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Kim M Phan, DONPI 1295001592

Title

Owner

Phone

(502) 418-4451

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim Minh Phan, D.O.

  • Internal Medicine Physician
  • Palm Springs, CA
  • NPI 1295001592
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1083211577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2466",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922632466",
            "telephone_number": "760-416-4800",
            "fax_number": "760-416-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR STE E218",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624885",
            "telephone_number": "760-416-4800",
            "fax_number": "760-416-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM PHAN DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-418-4451",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Khokhar, MD
• Liyona Khoury
• Reema Khurram, MD
• Helen Kienzle, PHD
• Brenda Kilzi, PHARMD
• Eun Tae Kim, REGISTEREDPHARMACIST
• Gemma Kim, M.D.
• Jimmy Kim, PHARM.D
• Soong Ha Kim, PHARMD
• Tae Kyu Kim, M.D.

• Hematology & Oncology Physician in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.

Verify at the official NPI Registry.