PHONG PHAN DO
NPI 1679223200
Student in an Organized Health Care Education/Training Program in Riverside, CA

Q: What is Phong Phan's NPI number?

The NPI number for Phong Phan is 1679223200. It was assigned to this individual provider in the NPPES registry on March 26, 2022.

Q: What is Phong Phan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Phong Phan was last updated on March 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 26, 2022PECOS Enrolled

4445 MAGNOLIA AVE, RIVERSIDE, CA 92501(951) 786-5350 Get Directions Write a Review

NPPES record last updated: March 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Phong Phan Do NPPES

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

PHONG PHAN DO (NPI 1679223200) is an individual student in an organized health care education/training program in Riverside, California and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679223200

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NamePHONG PHANCredential: DO

Location Address4445 MAGNOLIA AVERiverside, CA 92501-4135

Mailing Address4445 Magnolia AveRiverside, CA 92501-4135

Phone(951) 786-5350

Sole ProprietorNo

Enumeration DateMarch 26, 2022

NPPES CertifiedMarch 26, 2022

✔ NPI 1679223200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4445 MAGNOLIA AVE, Riverside, CA 92501

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phong Phan Do 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.

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.

MR. DAVID W LEVINE PA-C

Physician Assistant