Maylene Han Phangureh, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A14271 Issued in CA

Practice address

4050 Dublin Blvd
Dublin, CA 94568-3112

Phone

(925) 875-6100

NPI assigned

Jun 30, 2013

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 names 1

• Maylene Han Former name

Electronic endpoints 1

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

Family Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations (25 of 32)

Interoperability endpoints

• Direct secure messaging: mhan660148@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196

  Family Medicine

  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter East Bay Medical Foundation

  • Clinical Medical Laboratory
  • Berkeley, CA
  • NPI 1831381623
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

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

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1336589787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "925-875-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945683112",
            "telephone_number": "925-875-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 Sereno Dr",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945892441",
            "country_code": "US",
            "telephone_number": "707-651-4552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHANGUREH",
        "first_name": "MAYLENE",
        "middle_name": "HAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-30",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1425 S Main St",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945965318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MAYLENE",
            "last_name": "HAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dominique S Pham, DMD
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• Rocky Phan
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• Stephanie Phung
• Physiotherapy Associates, Inc.
• Stephanie Pierce
• Pillars Home Health Services, LLC

• Family Medicine Physician in Dublin, CA
• Providers in Dublin, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.