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

Mimi Yun Phan, MD

Individual provider Emergency Medicine Physician · NPI 1770767071

Mimi Yun Phan, MD is an Emergency Medicine in Sacramento, California. Qualified in 2006, 20 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
20
Licensed in
CA
In the registry since
2007
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

4150 V St Pssb 2100
Sacramento, CA 95817-1460
Phone: (916) 734-5010
Fax: (916) 734-7950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence A102225 (CA)

Record details

NPI number1770767071
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedDecember 21, 2007
Last updated in NPPESDecember 1, 2025
Certification dateDecember 1, 2025

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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