Kimmy Phan, - Medicare Occupational Therapist in Garden Grove, CA

Kimmy Phan, is a medicare enrolled "Occupational Therapist" provider in Garden Grove, California. Her current practice location is 11911 West St, Garden Grove, California. You can reach out to her office (for appointments etc.) via phone at (714) 467-9816.

Kimmy Phan is licensed to practice in California (license number 19050) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043843816.

Contact Information

Kimmy Phan,
11911 West St,
Garden Grove, CA 92840-2552
(714) 467-9816
Not Available



Healthcare Provider's Profile

Full NameKimmy Phan
GenderFemale
SpecialityOccupational Therapist
Location11911 West St, Garden Grove, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1043843816
  • Provider Enumeration Date: 02/19/2020
  • Last Update Date: 11/01/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 8527480748
  • Enrollment ID: I20200617000493

Medical Identifiers

Medical identifiers for Kimmy Phan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043843816NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 19050 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimmy Phan allows following entities to bill medicare on her behalf.
Provider NameSouthern California Permanente Medical Group
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1316979834
PECOS PAC ID: 6002729175
Enrollment ID: O20040126000823

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimmy Phan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kimmy Phan,
11911 West St,
Garden Grove, CA 92840-2552

Ph: (714) 467-9816
Kimmy Phan,
11911 West St,
Garden Grove, CA 92840-2552

Ph: (714) 467-9816

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Occupational Therapist in Garden Grove, CA

Katy Schlossberg,
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 12900b Garden Grove Blvd Ste 235, Garden Grove, CA 92843
Phone: 714-750-9700    Fax: 714-750-9797
Melinda Underwood, OTLP
Occupational Therapist
Medicare: Medicare Enrolled
Practice Location: 9618 Garden Grove Blvd, Garden Grove, CA 92844
Phone: 714-530-3115    
Ms. Tiffany Lui,
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 12900b Garden Grove Blvd Ste 235, Garden Grove, CA 92843
Phone: 714-750-9700    Fax: 714-750-9797
Danny Kang, OTR
Occupational Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 9828 Garden Grove Blvd, Suite 110, Garden Grove, CA 92844
Phone: 714-591-5853    
Christina Shin, OTD, OTR/L, CLT-LANA
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 12786 Newhope St, Garden Grove, CA 92840
Phone: 949-866-3570    
Duy Nguyen,
Occupational Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 12662 Kathy Ln, Garden Grove, CA 92840
Phone: 714-204-8402    

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