Robert Phan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4251 Long Beach Blvd Ste 102
Long Beach, CA 90807-2005

Phone

(210) 761-7617

NPI assigned

Feb 6, 2025

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tien T Nguyen M.D. Inc.Group PAC ID 0042318131, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Tien T Nguyen M.D. Inc.

  • Neurological Surgery Physician
  • Fountain Valley, CA
  • NPI 1063534204
  Medicare reassignment Care Compare group
• Waltzman Plastic and Reconstructive Surgery

  • Plastic Surgery Physician
  • Long Beach, CA
  • NPI 1598148942
  Medicare reassignment NPD
• Amniotti Inc

  • Multi-Specialty Clinic/Center
  • Beverly Hills, CA
  • NPI 1780465062
  Medicare reassignment

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762646400000",
    "number": "1467266536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042115",
            "telephone_number": "323-284-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 LONG BEACH BLVD STE 102",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072005",
            "telephone_number": "210-761-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-11-09",
        "certification_date": "2025-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Can Quang Phan, M.D.
• Hai Tran Phan
• Jane Phan, RNP
• Linh Vy Phan, O.D.
• Quoc Cong Phan
• Valerie Nhi Phan, COTA
• Van Thi-Kim Phan, DDS
• Vananh Phan, PHARMD
• Sovannaroth Phang, PHARMD
• Sokthea Phay

• Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2025; 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.