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

Annie Phan, PA-C

Individual provider Physician Assistant · NPI 1316581416

Annie Phan, PA-C is a Physician Assistant in Rancho Cucamonga, California. Qualified in 2020, 6 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

10787 Laurel St
Rancho Cucamonga, CA 91730-3828
Phone: (909) 982-7741
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1316581416
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 31, 2019
Last updated in NPPESOctober 27, 2023
Certification dateOctober 29, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Rancho Cucamonga