Mai Tuyet Phan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A051466 Issued in CA

Practice address

18625 Sherman Way
Suite #104
Reseda, CA 91335-4148

Phone

(818) 342-8171

Fax

(818) 342-8173

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Christine Phan Huynh Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mai Tuyet Phan Medical Clinic a Professional CorporationGroup PAC ID 2062684335, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Mai Tuyet Phan Medical Clinic a Professional Corporation

  • Health Service Clinic/Center
  • Reseda, CA
  • NPI 1588969026
  Medicare reassignment Care Compare group Authorized official
• Dignity Community Care

  • General Acute Care Hospital
  • Northridge, CA
  • NPI 1417089350
  NPD (past)
• Valley Presbyterian Hospital

  • General Acute Care Hospital
  • Van Nuys, CA
  • NPI 1578529285
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306879283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18625 SHERMAN WAY",
            "address_2": "SUITE #104",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354148",
            "telephone_number": "818-342-8171",
            "fax_number": "818-342-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18625 SHERMAN WAY",
            "address_2": "SUITE #104",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354148",
            "telephone_number": "818-342-8171",
            "fax_number": "818-342-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "MAI",
        "middle_name": "TUYET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A051466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A514660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "HUYNH",
            "middle_name": "PHAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lauren Schick Perez
• Maurice A Perry, D.P.M.
• Daniel Raymond Persichetti, P.T.
• David Pezhmannia, PHARM D
• Jonathan Pham, DMD
• Philip Korsun D O Inc
• Kiana Phillips, MA, OTR/L
• Honey Harriet Pietruszka, PSY.D.
• Marvin Pietruszka, M.D.
• Pinnacle Care Hospice, Inc.

• Internal Medicine Physician in Reseda, CA
• Providers in Reseda, CA by specialty
• Internal Medicine Physician in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.