Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Aivi Dolan Phung, PA-C

Individual provider Physician Assistant · NPI 1639528110

Aivi Dolan Phung, PA-C is a Physician Assistant in San Diego, California. Graduated from Loma Linda University School of Medicine in 2016, 10 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
10
Trained at
Loma Linda University School of Medicine
Licensed in
CA
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6973 Linda Vista Rd
San Diego, CA 92111-6342
Phone: (858) 279-0925
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5575 Ruffin Rd Ste 100, San Diego, CA 92123-1361 — (858) 277-2744

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA53902 (CA)

Record details

NPI number1639528110
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 6, 2016
Last updated in NPPESDecember 22, 2023
Certification dateSeptember 4, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in San Diego