Tuyet-Mai M. Phan, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G57670 Issued in CA

Practice address

9500 Bolsa Ave
Ste P
Westminster, CA 92683-5943

Phone

(714) 775-4400

Fax

(714) 775-0149

NPI assigned

Jul 25, 2006

Sex

Female

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

Other names 1

• T. Mai Phan Professional name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Harvard Medical School, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wolstan and Goldberg Eye Associates Inc a Medical CorporatonGroup PAC ID 9234266776, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• T Mai Phan MD Inc

  • Clinic/Center
  • Westminster, CA
  • NPI 1275835688
  Medicare reassignment NPD Authorized official
• Wolstan & Goldberg Eye Associates Inc a Medical Corporaton

  • Ophthalmology Physician
  • Torrance, CA
  • NPI 1285860445
  Medicare reassignment Care Compare group NPD
• Wolstan & Goldberg Eye Associates Inc., a Medical Corporaton

  • Eyewear Supplier
  • Torrance, CA
  • NPI 1669702288
  NPD
• Barry J Wolstan M D Inc.

  • Ophthalmology Physician
  • Torrance, CA
  • NPI 1639358492
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  NPD (past)
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• Torrance Memorial Medical Center

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1740268713

  Ophthalmology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1710900477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10681 BOLSA AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928435270",
            "telephone_number": "714-775-4400",
            "fax_number": "714-775-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 BOLSA AVE",
            "address_2": "STE P",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835943",
            "telephone_number": "714-775-4400",
            "fax_number": "714-775-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TUYET-MAI",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G57670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G576702",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "T. MAI",
            "last_name": "PHAN",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Phuong-CHI Phan, M.D.
• Quyen Ngoc Phan, RN
• Quynh Nhu Phan, DDS
• Susan Le Phan
• Tuan Van Phan, MD
• Van Thu Phan, DDS
• Vu Tuan Phan
• Kathy Phi, OTR/L
• Linda Phi, DDS
• Phong H. Tran Medical Corp

• Ophthalmology Physician in Westminster, CA
• Providers in Westminster, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.