THAO MINH PHAN (NPI# 1619113503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619113503 |
| Entity Type | Individual |
| Full Name | THAO MINH PHAN |
| Other Name | THAO MINH NGUYEN |
| Credential | M.D. |
| Practice Address |
1170 Baker St Ste H1 Costa Mesa CA 92626 |
| Mailing Address |
1170 Baker St Ste H1 Costa Mesa CA 92626-4165 |
| Practice Telephone | 9497913250 |
| Practice Fax Number | 9497913251 |
| Mailing Telephone | 9497913250 |
| Mailing Fax Number | 9497913251 |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2019-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A101844 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE RAILROAD | P00942853 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18785 Brookhurst St, Suite 200, Fountain Valley, CA 927087300 | 7143785330 | 7143785320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346896339 | Thao T Phan | Dietitian, Registered | 9692 Delafield Cir, Huntington Beach, CA 92646-3610 | 2019-08-15 |
| 1093921488 | Thao Mai Phan | Counselor | 14101 W Hwy 290, Suite 700a, Austin, TX 78737-9330 | 2007-05-15 |
| 1306849807 | Thao Hong Phan | Specialist | 3553 Whipple Rd, Union City, CA 94587-1507 | 2005-05-27 |
| 1275039901 | Thao Mien Phan | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2018-04-02 |
| 1972904530 | Thao Phan | Pharmacist | 4025 Delridge Way Sw, Seattle, WA 98106-1249 | 2014-09-12 |
| 1982018560 | Thao Phan | Pharmacist | 1809 Cecil Ave, Delano, CA 93215-1519 | 2014-06-11 |
| 1588979017 | Thao Thu Phan | Pharmacist | 2010 S Alma School Rd, Chandler, AZ 85286-7072 | 2010-08-09 |
| 1194900514 | Thao H Phan | Pharmacist | 1219 Amsterdam Ave, New York, NY 10027-7007 | 2008-01-03 |
| Street Address |
1170 BAKER ST STE H1 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710123609 | Chrystene A. Nguyen | Family Medicine | 1170 Baker St Ste H1, Costa Mesa, CA 92626-4165 | 2008-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639656358 | Md24 Oc, Inc | Family Medicine | Plaza Tower I 600 Anton Blvd, Suite 1100, Costa Mesa, AZ 92626 | 2018-07-25 |
| 1265919500 | Md24 La, Inc. | Family Medicine | 600 Anton Blvd Ste 1100, Costa Mesa, CA 92626-7100 | 2018-07-19 |
| 1699138511 | Vanessa Yu-wen Wu | Family Medicine | 1640 Newport Blvd Ste 300, Costa Mesa, CA 92627-7725 | 2016-03-29 |
| 1598032559 | John Hakkyun Kim | Family Medicine | 3195 Harbor Blvd Ste 3, Costa Mesa, CA 92626-2514 | 2011-11-18 |
| 1306028907 | Zaid Noman | Family Medicine | 131 E 17th St, Costa Mesa, CA 92627-3792 | 2007-12-05 |
| 1942408323 | Tarlan Ariana Nahidi | Family Medicine | 1190 Baker St Ste 100, Costa Mesa, CA 92626-4105 | 2007-07-06 |
| 1841402583 | Andrea Purcell | Family Medicine | 1770 Orange Ave, Portal To Healing, Costa Mesa, CA 92627 | 2007-05-04 |
| 1619194107 | Sara Tran Hong Chau | Family Medicine | 1190 W. Baker Street, Suite 100, Costa Mesa, CA 92626 | 2007-04-19 |
| 1922184076 | Stella D Pollack | Family Medicine | 3195 Harbor Blvd, Suite 3, Costa Mesa, CA 92626-2514 | 2006-10-31 |
| 1275628570 | Brian Michael Swan | Family Medicine | 3183 Airway Ave Ste F, Suite 104, Costa Mesa, CA 92626-4605 | 2006-10-03 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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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.