Individual provider · Type 1 NPI

Johnny Phan

Other Specialist/Technologist · San Diego, CA

NPI number 1114880705 Active

Practice location

10970 Polaris Dr
San Diego, CA 92126-2459

Call (858) 775-2261 Map

Specialties and licenses

TaxonomyCodeLicense
Other Specialist/Technologist Primary 246Z00000X4491866 (CA)

Other Specialist/Technologist: General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines.

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About NPI 1114880705

Johnny Phan's National Provider Identifier is 1114880705, issued on Dec 9, 2025. The primary taxonomy on file is Other Specialist/Technologist (246Z00000X), and the practice location is in San Diego, CA. The record was last updated on Dec 9, 2025.