MEDICARE: MIMI ANHTU PHAN O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	14705	CA
2	152WL0500X	Low Vision Rehabilitation Optometrist	14705	CA
3	152W00000X	Optometrist	14705	CA

General Provider Information

NPI Number	:	1598187924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIMI ANHTU PHAN O.D.

Provider Business Mailing Address
First Line	:	14726 RAMONA AVE STE 203
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-5730
Country	:	US
Telephone Number	:	626-305-9100
Fax Number	:	626-305-0152

Provider Business Practice Location Address
First Line	:	7677 CENTER AVE STE 301
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-3049
Country	:	US
Telephone Number	:	714-901-2007
Fax Number	:

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

Provider Enumeration Date	:	01/21/2014
Last Update Date	:	06/13/2024

Similar Medicare Providers

1033533195 — BRETT TOMPKINS DO
Practice Location Address:

7677 CENTER AVE STE 301
HUNTINGTON BEACH, CA
92647-3049

Practice Phone: 714-901-2007
Practice Fax: 714-901-2003

1982316683 — CINDY VAN TRUONG
Practice Location Address:

7677 CENTER AVE STE 301
HUNTINGTON BEACH, CA
92647-3049

Practice Phone: 714-901-2007
Practice Fax:

1154515039 — GOLDEN YEARS HOME HEALTH, INC.
Practice Location Address:

107 W. HUNTINGTON DRIVE , #F
ARCADIA, CA
91007-3049

Practice Phone: 626-445-2392
Practice Fax: 626-446-2984

1790648657 — INFUSE IQ LLC
Practice Location Address:

619B OCEANFRONT
LONG BEACH, NY
11561-3049

Practice Phone: 631-790-9436
Practice Fax:

1407746969 — BAPTIST AGEWELL PHYSICIANS INC
Practice Location Address:

1545 S 14TH ST
FERNANDINA BEACH, FL
32034-3049

Practice Phone: 904-202-4243
Practice Fax: 904-390-7415

1306392949 — ROSEMARY T WILSON APRN
Practice Location Address:

1545 S 14TH ST
FERNANDINA BEACH, FL
32034-3049

Practice Phone: 904-202-4243
Practice Fax: 904-390-7415

Directions to “ MIMI ANHTU PHAN O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.