Tuan Van Phan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A70808 Issued in CA

Practice address

10362 Bolsa Avenue
Bolsa Medical Group
Westminster, CA 92683-6763

Phone

(714) 531-2091

Fax

(714) 531-1403

NPI assigned

May 20, 2006

Sex

Male

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

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

University of California, Davis School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Bolsa Medical GroupGroup PAC ID 2769458264, 14 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: tphan1373732@oc.providencedirect.org
• Direct secure messaging: tuan.phan@bolsamg.directbygreenway.com

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.

• Bolsa Medical Group

  • Surgery Physician
  • Westminster, CA
  • NPI 1992732192

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Beaver Medical Group P C

  dba Optum

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319
  Medicare reassignment NPD
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Integrative Medical Center

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1215030747
  NPD (past)
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  NPD (past)
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1396799672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "address_2": "BOLSA MEDICAL GROUP",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10362 BOLSA AVENUE",
            "address_2": "BOLSA MEDICAL GROUP",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836763",
            "telephone_number": "714-531-2091",
            "fax_number": "714-531-1403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2251 N Harbor Blvd",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928352601",
            "country_code": "US",
            "telephone_number": "714-449-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TUAN",
        "middle_name": "VAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A70808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A708080",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tphan1373732@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2251 N Harbor Blvd",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928352601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenny Phan
• Phuong-CHI Phan, M.D.
• Quyen Ngoc Phan, RN
• Quynh Nhu Phan, DDS
• Susan Le Phan
• Tuyet-Mai M. Phan, M.D.
• Van Thu Phan, DDS
• Vu Tuan Phan
• Kathy Phi, OTR/L
• Linda Phi, DDS

• Family Medicine Physician in Westminster, CA
• Providers in Westminster, 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 Nov 9, 2021; 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.