MINDY THANH PHAN PA-C
NPI 1063996916
Physician Assistant in Tustin, CA

Q: What is Mindy Phan's NPI number?

The NPI number for Mindy Phan is 1063996916. It was assigned to this individual provider in the NPPES registry on September 17, 2018.

Q: What is Mindy Phan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mindy Phan was last updated on October 22, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 17, 2018PECOS Enrolled

661 W 1ST ST STE G, TUSTIN, CA 92780(714) 665-9890(714) 665-9891 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 12, 2023, Sep 17, 2018 (2 updates tracked since 2018).

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About Mindy Thanh Phan Pa-c NPPES

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

MINDY THANH PHAN PA-C (NPI 1063996916) is an individual physician assistant in Tustin, California, licensed in California (PA56216) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1063996916

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMINDY THANH PHANCredential: PA-C

Location Address661 W 1ST ST STE GTustin, CA 92780-2939

Mailing Address661 W 1st St Ste GTustin, CA 92780-2939 · (714) 665-9890 · Fax (714) 665-9891

Phone(714) 665-9890

Fax(714) 665-9891

Sole ProprietorYes

Enumeration DateSeptember 17, 2018

Last NPPES UpdateOctober 22, 20252 updates tracked since enumeration

NPPES CertifiedOctober 22, 2025

✔ NPI 1063996916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA56216

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

661 W 1ST ST STE G, Tustin, CA 92780

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Secondary Practice Locations 2

Location 111180 Warner Ave Ste 353Fountain Valley, CA 92708-7516 · Phone (714) 968-6789 · Fax (714) 202-2626

Location 29918 Katella Ave Ste A-CAnaheim, CA 92804-6465 · Phone (714) 644-9494 · Fax (714) 644-9894

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mindy Thanh Phan Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92780 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.