Phoenix Star Insurance

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

License

0K71317 Issued in CA

Legal business name

PHOENIX STAR INSURANCE

Practice address

10130 Garden Grove Blvd
Garden Grove, CA 92844-1689

Phone

(714) 876-7502

NPI assigned

Aug 17, 2016

Organization subpart

No

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

Authorized official

Name

Allan Ly

Title

Agency Owner

Phone

(714) 867-3977

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1215482450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441689",
            "telephone_number": "714-876-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX STAR INSURANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_title_or_position": "AGENCY OWNER",
        "authorized_official_telephone_number": "714-867-3977"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "CA",
            "license": "0K71317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vu Huy Phan, D.C, FNP-C, L.AC
• Phat L Tran DMD Inc
• Phil Trinh, DDS.,Inc
• Carmen Sabri Philip
• Patricia Phillips
• Teve Thongvanh Phommavongsa
• Andrew Phou
• Phu Van Dang, MD & Pauline Suong Thi Dang, MD, a Prof Medical Corp (Bolsa-Ward Medical Clinic, Inc.)
• Jennie Soi Phui, RDHAP
• Y Phun, MS

• Supports Brokerage Agency in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Supports Brokerage Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.