Kimmy Phan, | |
11911 West St, Garden Grove, CA 92840-2552 | |
(714) 467-9816 | |
Not Available |
Full Name | Kimmy Phan |
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Gender | Female |
Speciality | Occupational Therapist |
Location | 11911 West St, Garden Grove, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043843816 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 19050 (California) | Primary |
Provider Name | Southern California Permanente Medical Group |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
Mailing Address | Practice Location Address |
---|---|
Kimmy Phan, 11911 West St, Garden Grove, CA 92840-2552 Ph: (714) 467-9816 | Kimmy Phan, 11911 West St, Garden Grove, CA 92840-2552 Ph: (714) 467-9816 |
Katy Schlossberg, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12900b Garden Grove Blvd Ste 235, Garden Grove, CA 92843 Phone: 714-750-9700 Fax: 714-750-9797 | |
Melinda Underwood, OTLP Occupational Therapist Medicare: Medicare Enrolled Practice Location: 9618 Garden Grove Blvd, Garden Grove, CA 92844 Phone: 714-530-3115 | |
Ms. Tiffany Lui, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12900b Garden Grove Blvd Ste 235, Garden Grove, CA 92843 Phone: 714-750-9700 Fax: 714-750-9797 | |
Danny Kang, OTR Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 9828 Garden Grove Blvd, Suite 110, Garden Grove, CA 92844 Phone: 714-591-5853 | |
Christina Shin, OTD, OTR/L, CLT-LANA Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12786 Newhope St, Garden Grove, CA 92840 Phone: 949-866-3570 | |
Duy Nguyen, Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 12662 Kathy Ln, Garden Grove, CA 92840 Phone: 714-204-8402 |