Individual provider · Type 1 NPI

Jacklynne Phan

Physician Assistant · San Diego, CA

NPI number 1649904210 Active

Practice location

4282 Genesee Ave Ste 201
San Diego, CA 92117-4964

Call (858) 746-7882 Map

Fax (858) 505-1918

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA6777 (CA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1649904210

Jacklynne Phan's National Provider Identifier is 1649904210, issued on Jul 11, 2022. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in San Diego, CA. The record was last updated on Oct 28, 2025.