Alan Phu

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT304903 Issued in CA

Practice address

129 W Wilson St Ste 202
Costa Mesa, CA 92627-1586

Phone

(949) 631-0125

NPI assigned

Dec 11, 2023

Sex

Male

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progressive Physical Therapy and Rehabilitation IncGroup PAC ID 6800857434, 6 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.

• Progressive Physical Therapy and Rehabilitation Inc

  • Physical Therapist
  • Costa Mesa, CA
  • NPI 1912936840
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1649047416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16981 MOUNT EDEN ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 W WILSON ST STE 202",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271586",
            "telephone_number": "949-631-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHU",
        "first_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT304903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Ngoc Phan, M.D.
• Elizabeth Phelan, RN FNP-BC MSN
• Tracy Phelps
• Gaven Miran Phifer
• Lisa Kristina Phillips, PH.D.
• Phuc Dang, MD Corporation
• Audrey Phung
• Physiotherapy Associates Inc
• Jacob Piccolo
• Caitlin Cahill Pickart, M.D.

• Physical Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.