Individual provider Active NPI

Quy T Phan, PHARMD

  • Pharmacist
  • Travis Afb, CA
National Provider Identifier
1679430375
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH1001860 Issued in MA
Practice address
101 Bodin Cir BLDG 777
Travis Afb, CA 94535-1809
Phone
(707) 423-2388
NPI assigned
Jan 6, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH1001860 MA Primary

Addresses

Primary practice location

101 Bodin Cir BLDG 777
Travis Afb, CA 94535-1809

Mailing address

1200 Allison Dr Apt 5108
Vacaville, CA 95687-5040
Phone (603) 393-7731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH1001860MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1767657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1679430375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ALLISON DR APT 5108",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875040",
            "telephone_number": "603-393-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR BLDG 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "QUY",
        "middle_name": "T",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-06",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH1001860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.