Nghia John Phan, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC27279 Issued in CA

Practice address

433 Estudillo Ave Ste 100
San Leandro, CA 94577-4915

Phone

(510) 483-2836

Fax

(510) 483-3189

NPI assigned

Nov 15, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1659444081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774915",
            "telephone_number": "510-483-2836",
            "fax_number": "510-483-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774915",
            "telephone_number": "510-483-2836",
            "fax_number": "510-483-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "NGHIA",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0272790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanhanh Thi Pham, M.D.
• Andrew TJ Phan
• Dustin L Phan, PHARMD
• Huong Quynh Thi Phan, MPH
• Marissa Phan
• Varinder Singh Phangureh, M.D.
• Kenneth Scott Phelps, L.AC.
• Anthony Phillip
• Derek Michael Phillips
• Sarah Phillips

• Chiropractor in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.