MEDICARE: PHI PHI THI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		CA

General Provider Information

NPI Number	:	1134051030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHI PHI THI DO

Provider Business Mailing Address
First Line	:	14071 PEYTON DR UNIT 115
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-7104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14071 PEYTON DR UNIT 115
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-7104
Country	:	US
Telephone Number	:	800-275-8777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ PHI PHI THI DO ” Practice Location

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