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

Jason Michael Fan

Individual provider Family Medicine Physician · NPI 1629413687

Jason Michael Fan is a Family Practice in Anaheim, California. Qualified in 2013, 13 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
13
Licensed in
CA
In the registry since
2013
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Practice location Address checks out

1188 N Euclid St
Anaheim, CA 92801-1900
Phone: (714) 254-2727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A138157 (CA)

Record details

NPI number1629413687
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 3, 2013
Last updated in NPPESDecember 1, 2021
Mailing address1188 N Euclid St, Anaheim, CA 92801-1900

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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