Tam Phan

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

78948 Issued in CA

Practice address

1625 Schrader Blvd FL 1
Los Angeles, CA 90028-6213

Phone

(323) 993-7513

NPI assigned

Sep 24, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Los Angeles LGBT Center

  dba Jeffrey Goodman Special Care Pharmacy

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1437160637
  NPD (past)

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1386128585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 W JEFFERSON BLVD # 150",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900893604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD FL 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 Trousdale Pkwy",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900890046",
            "country_code": "US",
            "telephone_number": "213-740-2738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1510 San Pablo St Ste 144",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335394",
            "country_code": "US",
            "telephone_number": "323-442-5770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 W Jefferson Blvd # 150",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900893604",
            "country_code": "US",
            "telephone_number": "213-821-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "78948",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "CA",
            "license": "78948",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "78948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1910UAVS",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priscilla Phan, DO
• Quoc Hoa Phan, R.PH
• Ricky N Phan, DO
• Stephanie T Phan, M.D.
• Stephen Phan, MD
• Tina T Phan, PHARM.D.
• Tom Tuong-Gia Phan
• Trishia Thien-Trang Phan
• Tuan H Phan
• Tung Phan, P.A.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.