YEN PHAN D.O.
NPI 1891173142
Student in an Organized Health Care Education/Training Program in Fontana, CA

Active since May 07, 2015PECOS EnrolledAccepts Medicare Assignment
17234 VALLEY BLVD, FONTANA, CA 92335(909) 427-5000 Get Directions Write a Review

NPPES record last updated: December 2, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Yen Phan D.o. NPPES

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

YEN PHAN D.O. (NPI 1891173142) is an individual student in an organized health care education/training program in Fontana, California and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS and is a graduate of Western University Of Health Sciences College Of Dental Med (2015).

NPPES Registry Identity

NPI1891173142
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameYEN PHANCredential: D.O.
Location Address17234 VALLEY BLVDFontana, CA 92335
Mailing Address17234 Valley BlvdFontana, CA 92335
Sole ProprietorNo
Medical School CMSWestern University Of Health Sciences College Of Dental MedGraduated 2015
Enumeration DateMay 7, 2015
Last NPPES UpdateDecember 2, 2021
NPPES CertifiedDecember 2, 2021
✔ NPI 1891173142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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.
17234 VALLEY BLVD, Fontana, CA 92335

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Yen Phan D.o. 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 ID7719244235
PECOS Enrollment IDI20191122000729
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.

Medicare Billing Reassignment

Medicare enrollment records show Yen Phan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Health Maintenance Organization
9961 SIERRA AVE
Fontana, CA 92335
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1952333460 (California)
  • 5,228 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
Psychiatry & Neurology (Psychiatry)
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Family Medicine
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Family Medicine
17234 VALLEY BLVD
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335

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 Yen Phan's NPI number?

The NPI number for Yen Phan is 1891173142. It was assigned to this individual provider in the NPPES registry on May 7, 2015.

Where is Yen Phan located?

Yen Phan practices at 17234 Valley Blvd, Fontana, CA 92335. The listed phone number is (909) 427-5000.

What is Yen Phan's specialty?

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

Is Yen Phan enrolled in Medicare?

Yes. Yen 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.

Which organization bills Medicare for Yen Phan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Yen Phan reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Yen Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Yen Phan was last updated on December 2, 2021. 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.