Kathleen Catlan Phan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

34398 Issued in CA

Practice address

1355 4TH St
Santa Monica, CA 90401-1301

Phone

(310) 394-1011

NPI assigned

Jun 11, 2019

Last updated

Jan 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Sun and Dr Sjolund Optometric CorpGroup PAC ID 8820490147, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Sun and Dr Sjolund Optometric Corp

  dba Sunny Optometry

  • Optometrist
  • Santa Monica, CA
  • NPI 1316506132
  Medicare reassignment Care Compare group NPD
• Thanh-VI Nguyen, O.D., Inc.

  • Optometrist
  • Palm Desert, CA
  • NPI 1801154653
  NPD
• Emergency Medical & Surgical Specialists of Colorado LLC

  • Critical Access Hospital
  • Denver, CO
  • NPI 1144669102
  NPD (past)

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1427617505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 4TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011301",
            "telephone_number": "818-477-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 4TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011301",
            "telephone_number": "310-394-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KATHLEEN",
        "middle_name": "CATLAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002384",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacey Rachel Pflibsen, M.D.
• Anton Nguyen Pham, DO
• Christine Pham, PHARMD
• Jacqueline Van Pham
• Julia Kristina Pham, LPCC
• Pharmaca Integrative Pharmacy, Inc.
• Pharmacorp, Inc (Brentwood Pharmacy)
• Lori Pharris
• Phase IV
• Mark Dennis Phelan, LMFT

• Optometrist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.