Individual provider Active NPI

Vu Hong Phan, D.C.

  • Chiropractor
  • Hayward, CA
National Provider Identifier
1174740294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 28721 Issued in CA
Practice address
22551 2ND St
Suite 200
Hayward, CA 94541-4128
Phone
(510) 733-2225
Fax
(510) 733-2555
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 28721 CA Primary

Addresses

Primary practice location

22551 2ND St
Suite 200
Hayward, CA 94541-4128

Mailing address

22551 2ND St
Suite 200
Hayward, CA 94541-4128
Phone (510) 733-2225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DC 28721CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174740294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22551 2ND ST",
            "address_2": "SUITE 200",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414128",
            "telephone_number": "510-733-2225",
            "fax_number": "510-733-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22551 2ND ST",
            "address_2": "SUITE 200",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414128",
            "telephone_number": "510-733-2225",
            "fax_number": "510-733-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "VU",
        "middle_name": "HONG",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 28721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.