Julie Phan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

14612 Issued in CA

Practice address

1055 Harriman PL
San Bernardino, CA 92408-4203

Phone

(626) 382-9096

NPI assigned

Jun 7, 2013

Sex

Female

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Julie Phan OD IncGroup PAC ID 3072833011, 3 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Dr Julie Phan OD Inc

  • Optometrist
  • San Bernardino, CA
  • NPI 1013452234
  Medicare reassignment Care Compare group NPD Authorized official
• Richard Garratt OD Inc

  • Optometrist
  • San Dimas, CA
  • NPI 1457322737
  NPD
• Suzan Burmayan, O.D., a Professional Corporation

  • Optometrist
  • San Dimas, CA
  • NPI 1245077155
  NPD

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456617600000",
    "number": "1487092813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13250 DON JULIAN RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917462239",
            "telephone_number": "626-382-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 HARRIMAN PL",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084203",
            "telephone_number": "626-382-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2016-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie T Pham, PHARMD
• Lien Tran Pham, M.D
• Thanh Kim Pham, DDS
• Thanh Trung Pham
• Tuan Pham, DDS
• Ronald Phan
• Tim Phan, DPT
• Pharmacy Service Inc
• Pharmacy Service Inc
• Pharmacy Service Inc.

• Optometrist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2016; 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.