Kimberly Sue Phan, D.O

Primary specialty

OptometristTaxonomy code 152W00000X

License

13980 Issued in CA

Practice address

13662A Jamboree Rd
Irvine, CA 92620-1201

Phone

(714) 508-4972

NPI assigned

Sep 24, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.phan.p93@direct.nautilus.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)
• Newport Center Eye Specialists a Medical Corporation

  • Ophthalmology Physician
  • Newport Beach, CA
  • NPI 1881983716

  Optometrist

  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1912216987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 MAIN ST APT 2059",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926143200",
            "telephone_number": "951-522-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13662A JAMBOREE RD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201201",
            "telephone_number": "714-508-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuyen Thien Pham, PHARMD
• Anne Phan-Huy, MD
• Andrew Phan, MSPAS
• Cattien Ngoc Phan, DO
• Kim Phan, PA-C
• Maggie Ngan Phan, PHARM D.
• Michael Phan, PHARM.D.
• Nathan Phan
• Phuoc Huu Phan, DDS
• Shyanne Phan

• Optometrist in Irvine, CA
• Providers in Irvine, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.