Tung Phan MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A43113 Issued in CA

Legal business name

TUNG PHAN MD INC

Practice address

10152 Westminster Ave
Garden Grove, CA 92843-4754

Phone

(714) 530-3939

Fax

(714) 530-8388

NPI assigned

Mar 12, 2008

Organization subpart

Yes

Parent organization

TUNG PHAN MD INCAs reported in NPPES

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

Authorized official

Name

Mr. Tung Thanh Phan, MD

Title

Physician

Phone

(714) 530-3939

Specialties & licenses 1

Addresses

Part of

Tung Phan MD Inc

Locations

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1518138015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10152 WESTMINSTER AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434754",
            "telephone_number": "714-530-3939",
            "fax_number": "714-530-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10152 WESTMINSTER AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434754",
            "telephone_number": "714-530-3939",
            "fax_number": "714-530-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUNG PHAN MD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TUNG PHAN MD INC",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TUNG",
        "authorized_official_middle_name": "THANH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "714-530-3939",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A43113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.