Individual provider Active NPI

Tiffany Krista Fan, MD

  • Emergency Medicine Physician
  • Pasadena, CA
National Provider Identifier
1962151258
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A189411 Issued in CA
Practice address
100 W California Blvd
Pasadena, CA 91105-3010
Phone
(888) 388-7184
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A189411 CA Primary

Addresses

Primary practice location

100 W California Blvd
Pasadena, CA 91105-3010

Mailing address

PO Box 60259
Los Angeles, CA 90060-0259
Phone (877) 346-2211

Other practice location 1

1000 W Carson St
Torrance, CA 90502-2004
Phone (424) 306-5400

Other identifiers 1

IdentifierTypeStateIssuer
0OtherN/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241114003037 CA Practitioner - Emergency Medicine 0042744930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Geffen School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of San Gabriel ValleyGroup PAC ID 4082023726, 21 clinicians

Practice addresses (Care Compare)

438 W Las Tunas Dr
San Gabriel, CA 91776-1216
Phone (626) 289-5454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A189411CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of San Gabriel Valley Emergency Medicine CurrentSince Oct 15, 2024 Accepting new patients

Locations

438 W Las Tunas Dr
San Gabriel, CA 91776
Phone (626) 289-5454

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1962151258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60259",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900600259",
            "telephone_number": "877-346-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "888-388-7184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "424-306-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "TIFFANY",
        "middle_name": "KRISTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A189411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.