Hai Thuong Phan, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A41679 Issued in CA

Practice address

7223 Church St
Suite a-20
Highland, CA 92346

Phone

(909) 883-9283

Fax

(909) 886-6704

NPI assigned

Nov 2, 2005

Sex

Male

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hai T Phan

  • Nephrology Physician
  • Highland, CA
  • NPI 1114915485
  NPD (past) Authorized official
• California Cataract Center & Medical Group Inc

  • Specialist
  • Hemet, CA
  • NPI 1508815374
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1104817840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7223 CHURCH ST",
            "address_2": "SUITE A-20",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923465869",
            "telephone_number": "909-883-9283",
            "fax_number": "909-886-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7223 CHURCH ST",
            "address_2": "SUITE A-20",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "92346",
            "telephone_number": "909-883-9283",
            "fax_number": "909-886-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "HAI",
        "middle_name": "THUONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A41679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Marcia Perrotte, NP
• John Hany Peters, PHARMD
• Jonah Monique Peters
• Kelly Kim Dung Pham, PHARMD
• Paul P Pham, M.D.
• Natalie Aliyah Pineda
• Nikolas Matias Pintos, DDS
• Monica Renee Ponce de Leon
• Jocelyn Vanessa Portillo, BS
• Justin Prasad

• Nephrology Physician in Highland, CA
• Providers in Highland, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.