Douglas H. Phan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A114481 Issued in CA

Practice address

769 W Blaine St
Suite B
Riverside, CA 92507-3970

Phone

(951) 358-4705

NPI assigned

Jul 2, 2009

Last updated

Oct 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: douglas.phan@nhanhoa.directbygreenway.com

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.

• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1235283094
  Medicare reassignment NPD
• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment NPD
• Nhan Hoa Comprenesive Health Care Clinic Inc.

  dba Nhan Hoa Comprehensive Health Care Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Garden Grove, CA
  • NPI 1497889158
  Medicare reassignment NPD
• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Stanton, CA
  • NPI 1174757967
  NPD
• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Upland, CA
  • NPI 1174996318
  NPD
• County of Riverside

  dba Resident Education and Continuity Clinic

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1073815007
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD
• Nhan Hoa Comprehensive Health Care Clinic Inc

  dba Nhan Hoa Pharmacy

  • Community/Retail Pharmacy
  • Garden Grove, CA
  • NPI 1942752266
  NPD

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1366671992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 W BLAINE ST",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073970",
            "telephone_number": "951-358-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 W BLAINE ST",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073970",
            "telephone_number": "951-358-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "DOUGLAS",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A114481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Phan, PHARMACIST
• Anh Huynh Phan, MD
• Bryan Phan, PHARMD
• David Phan, D.M.D.
• Diane Dao Phan, MD
• Duy Phan, DO
• Hien Phan
• Huong Phan, PHARMD
• Jackie Phan
• Jimmy Phan, MD

• Psychiatry Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.