Individual provider Active NPI

Cynthia Cattuong Phan, DO

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
National Provider Identifier
1891373429
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
011725 Issued in AZ
Practice address
655 S Dobson Rd Ste 101
Chandler, AZ 85224-5668
Phone
(480) 459-2555
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 011725 AZ Primary

Addresses

Primary practice location

655 S Dobson Rd Ste 101
Chandler, AZ 85224-5668

Mailing address

655 S Dobson Rd Ste 101
Chandler, AZ 85224-5668
Phone (480) 459-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250721002323 AZ Practitioner - Obstetrics/Gynecology 6800302456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lilac Healthcare LLCGroup PAC ID 7911333596, 23 clinicians

Practice addresses (Care Compare)

655 S Dobson Rd
Suite A101
Chandler, AZ 85224-5667
Phone (480) 459-2555

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
011725AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lilac Healthcare LLC Obstetrics & Gynecology CurrentSince Jul 1, 2025 Accepting new patients

Locations

655 S Dobson Rd
Ste 101
Chandler, AZ 85224
Phone (480) 459-2555

655 S Dobson Rd
Ste A101
Chandler, AZ 85224
Phone (480) 855-5900

1501 N Gilbert Rd
Ste 160
Gilbert, AZ 85234
Phone (480) 633-0551

1489 S Higley Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 457-8800

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1891373429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S DOBSON RD STE 101",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245668",
            "telephone_number": "480-459-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S DOBSON RD STE 101",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245668",
            "telephone_number": "480-459-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "CYNTHIA",
        "middle_name": "CATTUONG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "011725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.