Sandy Phuong Phan

Primary specialty

TechnicianTaxonomy code 374700000X

Practice address

20342 Flanagan Road
Trabuco Canyon, CA 92679

Phone

(818) 582-8832

Fax

(818) 582-8836

NPI assigned

Nov 11, 2021

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1558027847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22431 B160 ANTONIO PARKWAY",
            "address_2": "#527",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "92688",
            "telephone_number": "714-986-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20342 FLANAGAN ROAD",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "92679",
            "telephone_number": "818-582-8832",
            "fax_number": "818-582-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "SANDY",
        "middle_name": "PHUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Park, PHARMD
• Courtney Elizabeth Pasqualetto, RADT
• Laura Ann Pawling, RADT
• Megan Pawling
• Peoples Pharmacy
• Christine Shirley Potapov, RADT
• Peyman Mohammad Pourarbab, D.C.
• Daisy Ramirez
• Angela P Reedy
• Helen Dawn Riccobono, M.A., LMFT

• Technician in Trabuco Canyon, CA
• Providers in Trabuco Canyon, CA by specialty
• Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.