Healthcare Provider Details

I. General information

NPI: 1184410375
Provider Name (Legal Business Name): HOA XUAN PHAN, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9356 WESTMINSTER BLVD
WESTMINSTER CA
92683-4704
US

IV. Provider business mailing address

9356 WESTMINSTER BLVD
WESTMINSTER CA
92683-4704
US

V. Phone/Fax

Practice location:
  • Phone: 714-621-5683
  • Fax: 714-462-5683
Mailing address:
  • Phone: 714-621-5683
  • Fax: 714-462-5683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HOA XUAN PHAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 714-621-5683