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GARY FAN MD
NPI 1063421311
Anesthesiology in Los Angeles, CA

Active since August 05, 2006PECOS EnrolledAccepts Medicare Assignment
1720 E CESAR E CHAVEZ AVE, LOS ANGELES, CA 90033(562) 407-2080 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Gary Fan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY FAN MD (NPI 1063421311) is an individual anesthesiology provider in Los Angeles, California, licensed in California (A87120) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1984).

NPPES Registry Identity

NPI1063421311
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameGARY FANCredential: MD
Location Address1720 E CESAR E CHAVEZ AVELos Angeles, CA 90033-2414
Mailing AddressPo Box 4259Cerritos, CA 90703-4259 · (562) 407-2080
Phone(562) 407-2080
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateAugust 5, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1063421311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in CA · A87120
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
1720 E CESAR E CHAVEZ AVE, Los Angeles, CA 90033
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Other Identifiers 2

Medicaid00A87120CA
Medicare ID-Type UnspecifiedA87120CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gary Fan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103805700
PECOS Enrollment IDI20040716000927
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Gary Fan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

White Memorial Medical Center
Same address
General Acute Care Hospital
1720 E CESAR E CHAVEZ AVE
Los Angeles, CA 90033
  • Reassigned Medicare billing, California enrollment
  • 131 clinicians in this Medicare group
NPI 1215927470 (323) 268-5000
Consultants For Anesthesia & Management Of Pain
6.9 mi
Anesthesiology
1509 WILSON TER
Glendale, CA 91206
  • Reassigned Medicare billing, California enrollment
  • 42 clinicians in this Medicare group
NPI 1952323909 (818) 409-8000
Glendale Adventist Medical Center
7.0 mi
Psychiatric Unit
1509 WILSON TER
Glendale, CA 91206
  • Reassigned Medicare billing, California enrollment
  • 164 clinicians in this Medicare group
NPI 1336138403 (818) 409-8000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NAYELI BUENROSTRO DPM
Student in an Organized Health Care Education/Training Program
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (323) 268-5000
PARDIS A SAFFARI DO
Internal Medicine
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (323) 260-5781
AH YEON CHANG RN
Registered Nurse (Case Management)
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (323) 268-5000
JOSIF BOROVIC, MD, INC
Pain Medicine (Interventional Pain Medicine)
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (562) 407-2080
CONNIE CHUNG MD
Student in an Organized Health Care Education/Training Program
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (323) 260-5781
DAVINA RENE HSU D.O.
Family Medicine
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (323) 268-5000
STELLA MARIE GOMORY PA-C
Physician Assistant
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (323) 268-5000
MARYAM FAKHRAI
Obstetrics & Gynecology
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033
Los Angeles County (949) 510-4227

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Fan's NPI number?

The NPI number for Gary Fan is 1063421311. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Where is Gary Fan located?

Gary Fan practices at 1720 E Cesar E Chavez Ave, Los Angeles, CA 90033. The listed phone number is (562) 407-2080.

What is Gary Fan's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Gary Fan enrolled in Medicare?

Yes. Gary Fan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Gary Fan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Fan reassigns Medicare benefits to 3 organizations: White Memorial Medical Center (Los Angeles, CA), Consultants For Anesthesia & Management Of Pain (Glendale, CA) and Glendale Adventist Medical Center (Glendale, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gary Fan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gary Fan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.