PETER BINH PHAN (NPI# 1558496174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558496174 |
| Entity Type | Individual |
| Full Name | PETER BINH PHAN |
| Credential | DMD |
| Practice Address |
16229 S Western Ave Ste 2 Gardena CA 90247 |
| Mailing Address |
16229 S Western Ave Ste 2 Gardena CA 90247-4660 |
| Practice Telephone | 4082563435 |
| Mailing Telephone | 4082563435 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2018-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
54722 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CA DMD LICENSE | 54722 | 01 |
| NV | DEA # | FP0137302 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811195563 | Peter Minh Phan | Nuclear Medicine | 9 Goldenrain, Aliso Viejo, CA 92656-2118 | 2007-07-04 |
| 1316998941 | Peter Phan | Emergency Medicine | 73153 Military Rd, Covington, LA 70435-6054 | 2006-05-16 |
| 1437769569 | Peter Phu Phan | Pharmacist | 3106 Solomons Island Rd, Edgewater, MD 21037-1701 | 2020-08-04 |
| 1073020657 | Peter Hoa Phan | Pharmacist | 275 W Ventura Blvd, Camarillo, CA 93010-8359 | 2018-01-04 |
| 1669789426 | Peter Phan | Home Health Aide | 379 University Ave W Ste 214, Saint Paul, MN 55103-2060 | 2010-08-31 |
| 1851564462 | Peter Phan | Surgery | 7780 S Broadway, Suite 250, Littleton, CO 80122-2648 | 2008-04-04 |
| 1285835884 | Peter Tan Phan | Dentist | 56 New Driftway, Scituate, MA 02066-4533 | 2007-05-30 |
| Street Address |
16229 S WESTERN AVE STE 2 |
| City | GARDENA |
| State | CA |
| Zip Code | 90247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699252411 | Peter Binh Phan Dmd Dental Corporation | Clinic/Center | 16229 S Western Ave Ste 2, Gardena, CA 90247-4660 | 2018-07-24 |
| 1912281700 | Hyo Jin Mun | Dentist | 16229 S Western Ave Ste 2, Gardena, CA 90247-4660 | 2011-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204707 | Melissa Reyes | Home Health Aide | 835 N Rosecrans Ave Apt 125, Gardena, CA 90247 | 2020-10-30 |
| 1538645569 | Christopher Jabarie Markham | Case Manager/Care Coordinator | 12817 S Hoover St Apt 14, Gardena, CA 90247 | 2018-07-12 |
| 1013404243 | Sunshine Community Resource Organization Center | Counselor | 1202 W 135th Street, Gardena, CA 90247 | 2018-04-13 |
| 1124537261 | Nina Vu | Pharmacist | 14416 Plum Lane, Unit 3, Gardena, CA 90247 | 2017-09-20 |
| 1356871008 | Delaram Moshfegh | Pharmacist | 1735 Artesia Blvd, Gardena, CA 90247 | 2017-06-15 |
| 1497290522 | Better Vision Optical | Eyewear Supplier (Equipment, not the service) | 1121 W Gardena Blvd Ste A, Gardena, CA 90247 | 2016-12-28 |
| 1013394832 | Lydia Gonzalez | Case Management | 13605 S Vermont Ave Apt 16, Gardena, CA 90247 | 2015-04-30 |
| 1396147682 | Daniel Medical Group, Inc. | Acupuncturist | 2015 W Redondo Beach Blvd., Ste F, Gardena, CA 90247 | 2014-09-18 |
| 1386913663 | Linda Doreen Humphries | Nurse Practitioner | 1141 W. Redondo Beach Blvd., Suite 402, Gardena, CA 90247 | 2011-12-15 |
| 1215229547 | Everett D Wong | Social Worker | 1045 W Redondo Beach Blvd Ste 150, Gardena, CA 90247 | 2011-05-04 |
| Find all providers in zip 90247 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144674433 | O.r. Barkhordar Dds Inc | Dentist | 1600 W. Redondo Beach Blvd, Ste 203, Gardena, CA 90274 | 2016-04-22 |
| 1457763716 | Luke B. Lee, Dmd Inc. | Dentist | 15632 S Normandie Ave, Gardena, CA 90247-4016 | 2014-05-21 |
| 1700137577 | John Yoo | Dentist | 15324 S Western Ave Ste E, Gardena, CA 90249-4338 | 2012-09-20 |
| 1912166612 | Bryan H Saiki | Dentist | 1875 W Redondo Beach Blvd Ste 203, Gardena, CA 90247-3643 | 2008-06-06 |
| 1750590394 | Craig Haruo Yamamoto | Dentist | 1157 W Gardena Blvd, Gardena, CA 90247-4823 | 2007-05-21 |
| 1831307610 | Teresa M. Avendano-galvez,dmd, A Professional Corporation | Dentist | 1451 W Artesia Blvd Ste 6, Gardena, CA 90248-3232 | 2007-05-18 |
| 1114146701 | Gayle N Kawahara | Dentist | 15300 S Western Ave, Gardena, CA 90249-4317 | 2007-04-24 |
| 1760514020 | David Bruce Akiyoshi | Dentist | 1133 W Gardena Blvd, Gardena, CA 90247-4823 | 2007-03-12 |
| 1023149341 | Rose Marie Baniqued Quimson | Dentist | 2926 Marine Ave, Gardena, CA 90249-3655 | 2007-03-08 |
| 1043348188 | Quy Van Ly | Dentist | 15422 Crenshaw Blvd, Gardena, CA 90249-4524 | 2007-03-01 |
| Find all providers in GARDENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.