Individual provider Active NPI

Hung Phi Phan, PHARMACIST

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1790782175
Registry record updated Jul 13, 2026
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jun 20, 2012.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH45283 Issued in CA
Practice address
702 E Santa Clara St
Suite #1
San Jose, CA 95112-1920
Phone
(408) 275-0858
Fax
(408) 275-0859
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH45283 CA Primary

Addresses

Primary practice location

702 E Santa Clara St
Suite #1
San Jose, CA 95112-1920

Mailing address

702 E Santa Clara St
Suite #1
San Jose, CA 95112-1920
Phone (408) 275-0858

Other identifiers 1

IdentifierTypeStateIssuer
PHA438820MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
RPH45283CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cali Pharmacy Pharmacist Past Accepting new patients

Organizations & group practices 1

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790782175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E SANTA CLARA ST",
            "address_2": "SUITE #1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121920",
            "telephone_number": "408-275-0858",
            "fax_number": "408-275-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 E SANTA CLARA ST",
            "address_2": "SUITE #1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121920",
            "telephone_number": "408-275-0858",
            "fax_number": "408-275-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "HUNG",
        "middle_name": "PHI",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH45283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA438820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.