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MIMI YUN PHAN M.D.
NPI 1770767071
Emergency Medicine in Sacramento, CA

Active since December 21, 2007PECOS EnrolledAccepts Medicare Assignment
4150 V ST, PSSB 2100, SACRAMENTO, CA 95817(916) 734-5010(916) 734-7950 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 1, 2025, Dec 1, 2021 (2 updates tracked since 2021).

About Mimi Yun Phan M.d. NPPES

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

MIMI YUN PHAN M.D. (NPI 1770767071) is an individual emergency medicine provider in Sacramento, California, licensed in California (A102225) and active in the NPI registry since December 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1770767071
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameMIMI YUN PHANCredential: M.D.
Location Address4150 V ST, PSSB 2100Sacramento, CA 95817-1460
Mailing Address4150 V St, Pssb 2100Sacramento, CA 95817-1460 · (916) 734-5010 · Fax (916) 734-7950
Phone(916) 734-5010
Fax(916) 734-7950
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateDecember 21, 2007
Last NPPES UpdateDecember 1, 20252 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1770767071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in CA · A102225
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
4150 V ST, Sacramento, CA 95817
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Other Names 1

Former Name (1)Mimi Yun Lee

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mimi Yun Phan M.d. 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 ID840356382
PECOS Enrollment IDI20090306000478
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 95817 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

KENNETH D. WHEELER CRNA
Nurse Anesthetist, Certified Registered
4150 V ST, PSSB-SUITE 1200, MED: ANESTHESIA
SACRAMENTO, CA 95817
Sacramento County (916) 734-7985
DR. MICHAEL JOHN THORNTON MD
Internal Medicine (Critical Care Medicine)
4150 V ST, SUITE 3400
SACRAMENTO, CA 95817
Sacramento County (916) 734-3566
THOMAS M. GOODNOW CRNA
Nurse Anesthetist, Certified Registered
4150 V ST, PSSB-SUITE 1200, MED: ANESTHESIA
SACRAMENTO, CA 95817
Sacramento County (916) 734-7985
DR. POURIA KASHKOULI M.D.
Internal Medicine
4150 V ST, #3116
SACRAMENTO, CA 95817
Sacramento County (916) 734-7080
DR. ALISON SEMRAD D.O.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
4150 V ST, #3116
SACRAMENTO, CA 95817
Sacramento County (916) 734-7080
DR. DIANE HADDOCK M.D.
Internal Medicine
4150 V ST, #3116
SACRAMENTO, CA 95817
Sacramento County (916) 734-7080
JOHN S MILLAR M.D.
Internal Medicine (Critical Care Medicine)
4150 V ST, SUITE 3400
SACRAMENTO, CA 95817
Sacramento County (916) 734-3564
UC DAVIS
General Acute Care Hospital
4150 V ST, 2100
SACRAMENTO, CA 95817
Sacramento County (916) 734-8583

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 Mimi Phan's NPI number?

The NPI number for Mimi Phan is 1770767071. It was assigned to this individual provider in the NPPES registry on December 21, 2007. The provider is also known as Mimi Yun Lee.

Where is Mimi Phan located?

Mimi Phan practices at 4150 V St Pssb 2100, Sacramento, CA 95817. The listed phone number is (916) 734-5010.

What is Mimi Phan's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Mimi Phan enrolled in Medicare?

Yes. Mimi Phan 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.

When was this NPI record last updated?

The NPPES record for Mimi Phan was last updated on December 1, 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.