Phong Phan, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

80481 Issued in CA

Practice address

84 010 Avenue 50
Coachella, CA 92236

Phone

(760) 391-5656

NPI assigned

Jan 28, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1710518915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 S ARAPAHO DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927042407",
            "telephone_number": "714-623-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 010 AVENUE 50",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "92236",
            "telephone_number": "760-391-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "PHONG",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "80481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandra N Patel, PHARM D.
• Mariah Pavia
• Samanta Pena Tovar
• Bethzaira Pena
• Sandra C Perez, B.A.
• Israel Pineda
• Lyneeka Pittman
• Planned Parenthood of the Pacific Southwest
• Evelyn Ponce Rangel, MSW, ACSW
• Janet Ponce

• Pharmacist in Coachella, CA
• Providers in Coachella, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.