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CONG T. PHAN M.D., INC.
NPI 1114354396
Internal Medicine in Rancho Cucamonga, CA

Active since October 02, 2013CLIA 05D2296754 · Waiver
8235 ROCHESTER AVE STE 110, RANCHO CUCAMONGA, CA 91730(909) 484-4900(909) 781-2949 Get Directions Write a Review

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cong T. Phan M.d., Inc. NPPES

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

CONG T. PHAN M.D., INC. (NPI 1114354396) is a healthcare organization registered as an internal medicine in Rancho Cucamonga, California and active in the NPI registry since October 2013. The organization holds a CLIA Waiver certificate valid through January 3, 2028, maintains a secondary practice location in Montclair, and lists Cong T. Phan, President, as its authorized official.

NPPES Registry Identity

NPI1114354396
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCONG T. PHAN M.D., INC.
Location Address8235 ROCHESTER AVE STE 110Rancho Cucamonga, CA 91730-0719
Mailing Address9303 Jasmine AveFountain Valley, CA 92708-1960 · (909) 941-4777
Phone(909) 484-4900
Fax(909) 781-2949
Organization SubpartNo
Authorized OfficialCong T. PhanPresident · (909) 941-4777
Enumeration DateOctober 2, 2013
Last NPPES UpdateSeptember 25, 2024
NPPES CertifiedSeptember 25, 2024
✔ NPI 1114354396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
8235 ROCHESTER AVE STE 110, Rancho Cucamonga, CA 91730
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Secondary Practice Location 1

Location 14950 San Bernardino St Ste 107Montclair, CA 91763-2328 · Phone (909) 963-0800 · Fax (909) 296-7999

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2296754

Cong T Phan · Rancho Cucamonga, CA
Active · expires Jan 3, 2028
CLIA Number05D2296754
Laboratory TypePhysician Office
Certificate Effective DateJanuary 4, 2026
Certificate Expiration DateJanuary 3, 2028
Laboratory DirectorCong T. Phan
Laboratory Phone(909) 484-4900
Laboratory LocationCong T Phan8235 Rochester Ave Ste 110, Rancho Cucamonga, CA 91730
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

MONICA B XIE NP
Nurse Practitioner (Family)
8235 ROCHESTER AVE STE 110
RANCHO CUCAMONGA, CA 91730
San Bernardino County (909) 484-4900
DR. CONG THANH PHAN M.D.
Internal Medicine
8235 ROCHESTER AVE STE 110
RANCHO CUCAMONGA, CA 91730
San Bernardino County (909) 484-4900
VIET D. TA, MD & TIFFANY L. QUAN, MD MEDICAL ASSOCIATES INC.
Family Medicine
8235 ROCHESTER AVE STE 110
RANCHO CUCAMONGA, CA 91730
San Bernardino County (909) 484-4900
AMY DO PA-C
Physician Assistant
8235 ROCHESTER AVE STE 110
RANCHO CUCAMONGA, CA 91730
San Bernardino County (909) 484-4900

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 Cong T. Phan M.D., Inc.'s NPI number?

The NPI number for Cong T. Phan M.D., Inc. is 1114354396. It was assigned to this organization in the NPPES registry on October 2, 2013.

Where is Cong T. Phan M.D., Inc. located?

Cong T. Phan M.D., Inc. is located at 8235 Rochester Ave Ste 110, Rancho Cucamonga, CA 91730. The listed phone number is (909) 484-4900.

What is Cong T. Phan M.D., Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Cong T. Phan M.D., Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2296754) is associated with this NPI, valid through January 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cong T. Phan M.D., Inc. was last updated on September 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.