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KIMLONG NGUYEN PHAN
NPI 1780494344
Physician Assistant in Pomona, CA

Active since January 07, 2025PECOS Enrolled
1798 N GAREY AVE, POMONA, CA 91767(909) 865-9500 Get Directions Write a Review

NPPES record last updated: March 1, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 1, 2025, Jan 7, 2025 (2 updates tracked since 2025).

About Kimlong Nguyen Phan NPPES

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

KIMLONG NGUYEN PHAN (NPI 1780494344) is an individual physician assistant in Pomona, California, licensed in California (66053) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780494344
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKIMLONG NGUYEN PHAN
Location Address1798 N GAREY AVEPomona, CA 91767-2918
Mailing Address1086 S Thomas StPomona, CA 91766-3236 · (909) 524-6996
Phone(909) 865-9500
Sole ProprietorNo
Enumeration DateJanuary 7, 2025
Last NPPES UpdateMarch 1, 20252 updates tracked since enumeration
NPPES CertifiedMarch 1, 2025
✔ NPI 1780494344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 66053
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1798 N GAREY AVE, Pomona, CA 91767
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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)

Kimlong Nguyen Phan 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 91767 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.

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.

MARIA CONSUELO CASTELAN RD
Dietitian, Registered
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (909) 528-5046
HSIENHWA CHOU RD
Dietitian, Registered
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (909) 860-7799
MR. CYRUS QUEROL P.A.
Physician Assistant
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (510) 350-2698
VESTA NICOLE GUIV PHARMD
Pharmacist
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (909) 865-9500
JENJIRA SORRECA DO RD
Dietitian, Registered
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (909) 865-9501
VICTORIA SUSAN CHIDBOY RN
Registered Nurse (Critical Care Medicine)
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (909) 865-9500
MARTI JO KUNISHIMA PT
Physical Therapist
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (909) 865-9810
RACHEL ANN CHATER LEA
Physician Assistant
1798 N GAREY AVE
POMONA, CA 91767
Los Angeles County (949) 973-3290

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 Kimlong Phan's NPI number?

The NPI number for Kimlong Phan is 1780494344. It was assigned to this individual provider in the NPPES registry on January 7, 2025.

Where is Kimlong Phan located?

Kimlong Phan practices at 1798 N Garey Ave, Pomona, CA 91767. The listed phone number is (909) 865-9500.

What is Kimlong Phan's specialty?

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

Is Kimlong Phan enrolled in Medicare?

Yes. Kimlong Phan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimlong Phan was last updated on March 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.