Thomas Ngoc Phan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A170266 Issued in CA

Practice address

1640 Newport Blvd Ste 110
Costa Mesa, CA 92627-7762

Phone

(925) 282-1778

Fax

(415) 296-5299

NPI assigned

May 11, 2017

Last updated

Feb 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 19, 2026 through Feb 19, 2028

Specialty

Psychiatry

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lifestancehealth.thomasphan@148377.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark David Levine, MD Burlingame PC

  dba Community Psychiatry Associates

  • Psychiatry Physician
  • San Mateo, CA
  • NPI 1770709263
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1740716687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD STE 110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277762",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD STE 110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277762",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Newport Center Dr Ste 235",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926600903",
            "country_code": "US",
            "telephone_number": "949-999-4120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "THOMAS",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "BP10060945",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A170266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Pham, PHARM D
• Viet Hoang Pham
• Allison My-Duyen Phan
• Sandy Phan, DMD
• Thao Minh Phan, M.D.
• Elizabeth Phelan, RN FNP-BC MSN
• Tracy Phelps
• Gaven Miran Phifer
• Lisa Kristina Phillips, PH.D.
• Megen Phillips

• Psychiatry Physician in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• 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.