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

Kimlong Nguyen Phan

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1780494344

Kimlong Nguyen Phan is a Student in an Organized Health Care Education/Training Program in Pomona, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025
Specialties on file
2

Practice location Address checks out

1798 N Garey Ave
Pomona, CA 91767-2918
Phone: (909) 865-9500
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 66053 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (CA)

Record details

NPI number1780494344
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 7, 2025
Last updated in NPPESMarch 1, 2025
Certification dateMarch 1, 2025

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