Leanne Phan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA67948 Issued in CA

Practice address

12665 Garden Grove Blvd Ste 304
Garden Grove, CA 92843-1917

Phone

(714) 537-5302

Fax

(714) 537-0592

NPI assigned

Apr 20, 2026

Last updated

Sep 17, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1427993344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 304",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "657-263-5124",
            "fax_number": "714-537-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 304",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "714-537-5302",
            "fax_number": "714-537-0592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Century Park E Ste 710",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900672010",
            "country_code": "US",
            "telephone_number": "310-715-3237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LEANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenny H Phan, CRT
• Kevin Phan
• Khanh Phan, MA
• Kim Nguyen Phan, PH.D.
• Kimmy Phan
• Lynda Phan
• Mikey Phan
• Mindy Trieu Phan, D.M.D
• Nguyen Quoc Phan
• Quang Quoc Phan, M.D.

• Physician Assistant in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.