Anthony Thong Phan MD Inc

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

G83470 Issued in CA

Legal business name

ANTHONY THONG PHAN MD INC

Practice address

1189 Swallow LN Ste 110
Simi Valley, CA 93065-3157

Phone

(805) 526-3213

Fax

(805) 583-5929

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Thong Phan, M.D.NPI 1124207006

Title

President Ceo

Phone

(805) 526-3213

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony Thong Phan, M.D.

  • Internal Medicine Physician
  • Simi Valley, CA
  • NPI 1124207006
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1730139353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 SWALLOW LN STE 110",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653157",
            "telephone_number": "805-526-3213",
            "fax_number": "805-583-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 SWALLOW LN STE 110",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653157",
            "telephone_number": "805-526-3213",
            "fax_number": "805-583-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY THONG PHAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "THONG",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "805-526-3213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G83470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "00G834700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0989497",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anita Kaul MD Inc
• Ann Knight
• Anna Gold Co., Inc.
• Annan Counseling Clinic
• Ingrid Woelfl Antall, MD
• Heidi Ann Anticevich, PTA
• Jane Antonelli, PT
• Apnadent LLC
• Aprn-Specialized Nursing Consultant Inc.
• Tyler James Arauza, B.A., R.B.T.

• Geriatric Medicine (Internal Medicine) Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Geriatric Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.