DEREK Q PHAN MD NPI 1598184244

NPI Information

NPI: 1598184244
Provider Name: DEREK Q PHAN, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
21634 RETREAT PKWY
TEMESCAL VALLEY, CA
ZIP 92883
Phone: (951) 493-6650
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Derek Q Phan, MD is a cardiovascular disease internal medicine in Temescal Valley, CA with 10 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Derek Q Phan, MD NPI is 1598184244. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

21634 RETREAT PKWY
TEMESCAL VALLEY, CA
ZIP 92883-100
Phone: (951) 493-6650

The NPI 1598184244 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/9/2014 and was last updated on 7/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		MD61123756	WASHINGTON	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	0447579	KANSAS	No
3	207RC0000X	Internal Medicine	Cardiovascular Disease	A138554	CALIFORNIA	No
4	207RI0011X	Internal Medicine	Interventional Cardiology	100522	WISCONSIN	No
5	207RI0011X	Internal Medicine	Interventional Cardiology	MD61123756	WASHINGTON	No
6	207RI0011X	Internal Medicine	Interventional Cardiology	0447579	KANSAS	No
7	207RI0011X	Internal Medicine	Interventional Cardiology	A138554	CALIFORNIA	No
8	207RC0000X	Internal Medicine	Cardiovascular Disease	100522	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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