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

Dr. Jimmy Ninh Hoang Phan, MD

Individual provider Pediatrics Physician · NPI 1770928962

Dr. Jimmy Ninh Hoang Phan, MD is a Pediatrics Physician in Lake Elsinore, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2013
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

425 Diamond Dr Ste 103
Lake Elsinore, CA 92530-4495
Phone: (951) 981-3122
Fax: (951) 981-3123
Show map & directions

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

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 141765 (CA)

Record details

NPI number1770928962
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 2, 2013
Last updated in NPPESJanuary 27, 2022
Certification dateJanuary 27, 2022

Other providers in Lake Elsinore