JOHNNY PHAN
NPI 1114880705
Specialist/Technologist, Other in San Diego, CA

Q: What is Johnny Phan's NPI number?

The NPI number for Johnny Phan is 1114880705. It was assigned to this individual provider in the NPPES registry on December 9, 2025.

Q: What is Johnny Phan's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other with taxonomy code 246Z00000X.

Q: When was this NPI record last updated?

The NPPES record for Johnny Phan was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since December 09, 2025

10970 POLARIS DR, SAN DIEGO, CA 92126(858) 775-2261 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Johnny Phan NPPES

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

JOHNNY PHAN (NPI 1114880705) is an individual specialist/technologist, other provider in San Diego, California, licensed in California (4491866) and active in the NPI registry since December 2025.

NPPES Registry Identity

NPI1114880705

Entity TypeIndividualMale

Primary Taxonomy246Z00000X

Provider Legal NameJOHNNY PHAN

Location Address10970 POLARIS DRSan Diego, CA 92126-2459

Mailing Address10970 Polaris DrSan Diego, CA 92126-2459 · (858) 775-2261

Phone(858) 775-2261

Sole ProprietorYes

Enumeration DateDecember 9, 2025

NPPES CertifiedDecember 9, 2025

✔ NPI 1114880705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist, OtherTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code246Z00000X

License✔ Licensed in CA · 4491866

Definition

General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines.

10970 POLARIS DR, San Diego, CA 92126

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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 Johnny Phan's NPI number?

The NPI number for Johnny Phan is 1114880705. It was assigned to this individual provider in the NPPES registry on December 9, 2025.

Where is Johnny Phan located?

Johnny Phan practices at 10970 Polaris Dr, San Diego, CA 92126. The listed phone number is (858) 775-2261.

What is Johnny Phan's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other with taxonomy code 246Z00000X.

When was this NPI record last updated?

The NPPES record for Johnny Phan was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.