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

Individual provider Adult Health Nurse Practitioner · NPI 1093674970

Phivan Pham-Ccasa is a Nurse Practitioner in Los Angeles, California. Qualified in 2025, 1 year ago. Practices with Apex Multispecialty Medical Group Inc, a 10-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2026
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Practice location Address checks out

600 S San Vicente Blvd
Los Angeles, CA 90048-4653
Phone: (310) 873-3312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence NP95038118 (CA)

Record details

NPI number1093674970
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 16, 2026
Last updated in NPPESApril 6, 2026
Certification dateApril 6, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Apex Multispecialty Medical Group Inc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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