Individual provider Active NPI

Andrew Phung

  • Family Medicine Physician
  • Pasadena, CA
National Provider Identifier
1467031971
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A22573 Issued in CA
Practice address
10 Congress St Ste 208
Pasadena, CA 91105-3027
Phone
(626) 792-2166
Fax
(626) 795-0740
NPI assigned
Apr 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 20A22573 CA Primary

Addresses

Primary practice location

10 Congress St Ste 208
Pasadena, CA 91105-3027

Mailing address

10 Congress St Ste 208
Pasadena, CA 91105-3027
Phone (626) 792-2166

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240722001319 CA Practitioner - Family Practice 1355887712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 Congress St
Suite 208
Pasadena, CA 91105-3027
Phone (626) 792-2166

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
The Huntington Medical Foundation Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Pih Health Physicians CurrentSince May 8, 2024 Accepting new patients
Pih Health Physicians CurrentSince May 8, 2024 Accepting new patients
Pih Health Physicians Family Medicine Current Accepting new patients
Huntington Medical Foundation Family Medicine Past Accepting new patients

Locations

11500 Brookshire Ave
Ofc
Downey, CA 90241
Phone (562) 904-5000

1400 S Harbor Blvd
La Habra, CA 90631
Phone (714) 879-3400

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

10 Congress St
Ste 208
Pasadena, CA 91105
Phone (626) 792-2166

65 N Madison Ave
Ste 800
Pasadena, CA 91101
Phone (626) 792-3141

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: andrewphung@pihh.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1467031971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CONGRESS ST STE 208",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053027",
            "telephone_number": "626-792-2166",
            "fax_number": "626-795-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONGRESS ST STE 208",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053027",
            "telephone_number": "626-792-2166",
            "fax_number": "626-795-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A22573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.