Vu Phan, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C55621 Issued in CA

Practice address

16899 W Bernardo Dr
San Diego, CA 92127-1603

Phone

(858) 499-2600

NPI assigned

Apr 19, 2007

Last updated

Jul 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, CA2 enrollments

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 2

Specialty

Emergency MedicineAlso: Family Practice

Education

Medical College of Wisconsin, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital, Riverside Hospital, Riverside, CA, CCN 050686

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177

  Emergency Medicine

  Medicare reassignment NPD
• Aultman Hospital

  • Specialist
  • Canton, OH
  • NPI 1619911054
  Medicare reassignment NPD
• Caep-Dunlap, LLC

  • Emergency Medicine Physician
  • Canton, OH
  • NPI 1669709911
  Medicare reassignment NPD
• Canton Aultman Emergency Physicians Inc

  • Emergency Medicine Physician
  • Canton, OH
  • NPI 1801832381
  Medicare reassignment NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1063172351
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  NPD
• Aultman Hospital

  dba Aultman Employee Pharmacy

  • Community/Retail Pharmacy
  • Canton, OH
  • NPI 1700941978
  NPD
• Stark County Pathologists Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Canton, OH
  • NPI 1194030437
  NPD
• Emergency Medicine Physicians of Barberton, LTD

  • Emergency Medicine Physician
  • Barberton, OH
  • NPI 1154360089
  NPD (past)
• General Emergency Medical Specialists, Inc.

  dba Gems

  • Emergency Medicine Physician
  • Akron, OH
  • NPI 1821055856
  NPD (past)

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital, Riverside

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1306991211
  Care Compare affiliation

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1902023336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16899 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271603",
            "telephone_number": "858-499-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16899 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271603",
            "telephone_number": "858-499-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 5th St NE",
            "address_purpose": "LOCATION",
            "city": "Barberton",
            "state": "OH",
            "postal_code": "442033332",
            "country_code": "US",
            "telephone_number": "330-493-4443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "VU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2022-07-25",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "89527",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C55621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Phan
• Trang Phan
• Tri Duc Phan, O.D.
• Tuyet Thi Phan, PHARMD
• Valorie Phan
• William Phan, DPT
• Xuan Phan, PHARMD
• Shivani Phanse, DPM
• Cassandra Nicole Phares, LMFT
• Pharmaca Integrative Pharmacy

• Emergency Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.