Aida S. Phelan, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A062622 Issued in CA

Practice address

1621 Creekside Drive
Suite 102
Folsom, CA 95630

Phone

(916) 984-7428

Fax

(916) 984-0157

NPI assigned

Dec 15, 2005

Last updated

Oct 22, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sutter North Medical Foundation

  dba Sutter North Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1245216811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 CREEKSIDE DRIVE",
            "address_2": "SUITE 102",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-984-7428",
            "fax_number": "916-984-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 CREEKSIDE DRIVE",
            "address_2": "SUITE 102",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-984-7428",
            "fax_number": "916-984-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "AIDA",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A062622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN INDEX #",
            "identifier": "006631",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Pettus
• Phaedrus Consulting, LLC (New Planes)
• Hanh Thi Pham, D.D.S.
• Tiffany H Phan, OD, FAAO
• Alicia Cherie Pharis
• Timothy Edwin Phelan, M.D.
• Tracy Phelps
• Julie Ann Huat Phenco, M.D.
• Nayah Phetdara
• Philip J Orisek, M.D. Inc.

• Anesthesiology Physician in Folsom, CA
• Providers in Folsom, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.