Individual provider Active NPI

Dien Phung, PA-C

  • Medical Physician Assistant
  • Sacramento, CA
National Provider Identifier
1699582411
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA67244 Issued in CA
Practice address
3030 Explorer Dr
Sacramento, CA 95827-2728
Phone
(916) 642-1867
Fax
(844) 491-6066
NPI assigned
Dec 16, 2024
Last updated
Jun 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA67244 CA Primary

Addresses

Primary practice location

3030 Explorer Dr
Sacramento, CA 95827-2728

Mailing address

3030 Explorer Dr
Sacramento, CA 95827-2728
Phone (916) 642-1867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260311003930 CA Order and Referring Only - Physician Assistant 4486137064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA67244CAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1699582411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 EXPLORER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272728",
            "telephone_number": "916-642-1867",
            "fax_number": "844-491-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 EXPLORER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272728",
            "telephone_number": "916-642-1867",
            "fax_number": "844-491-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "DIEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA67244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.