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

Individual provider Physician Assistant · NPI 1033931621

Kenny Phan, PA-C is a Physician Assistant in Santa Clara, California. Qualified in 2024, 2 years ago. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
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

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone: (408) 851-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1033931621
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 25, 2024
Last updated in NPPESNovember 3, 2025
Certification dateNovember 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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