Healthcare Provider Details

I. General information

NPI: 1427842111
Provider Name (Legal Business Name): STEVEN NGUYEN-ANH PHAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 S GLEBE RD
ARLINGTON VA
22204-4354
US

IV. Provider business mailing address

1020 S GLEBE RD
ARLINGTON VA
22204-4354
US

V. Phone/Fax

Practice location:
  • Phone: 703-420-7311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6868
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618003580
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: