Individual provider Active NPI

Tiffany Phan

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1194650101
Registry record updated Jun 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7280 Canyon Breeze Rd
San Diego, CA 92126-2067
Phone
(858) 231-6650
NPI assigned
Jun 13, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

7280 Canyon Breeze Rd
San Diego, CA 92126-2067

Mailing address

7280 Canyon Breeze Rd
San Diego, CA 92126-2067
Phone (858) 231-6650

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781308800000",
    "number": "1194650101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7280 CANYON BREEZE RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262067",
            "telephone_number": "858-231-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7280 CANYON BREEZE RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262067",
            "telephone_number": "858-231-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-13",
        "last_updated": "2026-06-13",
        "certification_date": "2026-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2026; 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.