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

Individual provider Obstetrics & Gynecology Physician · NPI 1336250836

Dr. Kenneth Phan, MD is an Obstetrics/Gynecology in San Jose, California. Graduated from Tufts University School of Medicine in 1998, 28 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
28
Trained at
Tufts University School of Medicine
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

150 N Jackson Ave Ste 209
San Jose, CA 95116-1908
Phone: (408) 929-2680
Fax: (408) 929-4635
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence A77173 (CA)

Record details

NPI number1336250836
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 31, 2006
Last updated in NPPESApril 29, 2013

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolTUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1998 (28 years in practice)
Accepts Medicare assignment Not indicated

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