Individual provider Active NPI

Hoang-Lan Phan

  • Family Nurse Practitioner
  • Pacific Grove, CA
National Provider Identifier
1710875554
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95036308 Issued in CA
Practice address
1120 Forest Ave # 138
Pacific Grove, CA 93950-5105
Phone
(831) 200-9651
NPI assigned
Jun 27, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95036308 CA Primary
Registered Nurse 163W00000X 95159511 CA

Addresses

Primary practice location

1120 Forest Ave # 138
Pacific Grove, CA 93950-5105

Mailing address

1120 Forest Ave # 138
Pacific Grove, CA 93950-5105
Phone (831) 200-9651

Other practice location 1

8170 Murray Ave
Gilroy, CA 95020-4605
Phone (408) 842-9311

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
I20250919002061 CA Practitioner - Nurse Practitioner 5698279883 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solomon Medical IncGroup PAC ID 4385041334, 31 clinicians
Solomon Physicians Group PCGroup PAC ID 6709385677, 14 clinicians

Practice addresses (Care Compare)

1501 Skyline Dr
Monterey, CA 93940-4110
Phone (831) 402-8728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95159511CAMDRegistered Nurse
95036308CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Solomon Medical Inc CurrentSince Aug 25, 2025 Accepting new patients
Solomon Medical Inc Current Accepting new patients
Solomon Physicians Group PC CurrentSince Feb 1, 2026 Accepting new patients

Locations

8170 Murray Ave
Gilroy, CA 95020
Phone (408) 842-9311

1501 Skyline Dr
Monterey, CA 93940
Phone (831) 200-9651

2530 Solace Pl
Mountain View, CA 94040
Phone (650) 502-1800

1120 Forest Ave
Pacific Grove, CA 93950
Phone (831) 200-9651

637 E Romie Ln
Salinas, CA 93901
Phone (831) 424-0687

1990 Fruitdale Ave
San Jose, CA 95128
Phone (408) 998-8447

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1710875554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 FOREST AVE # 138",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939505105",
            "telephone_number": "831-200-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 FOREST AVE # 138",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939505105",
            "telephone_number": "831-200-9651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8170 Murray Ave",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950204605",
            "country_code": "US",
            "telephone_number": "408-842-9311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "HOANG-LAN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-27",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95036308",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95159511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

Verify at the official NPI Registry.