Doctor profile · Federal record

Dr. Theodore Phan

Physician Assistant · Student in an Organized Health Care Education/Training Program · Novato, CA

  • NPI 1104546969
  • MIPS 86.3 / 100 · 2023
  • 4 yrs on file
  • Male
  • Solo practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
52 Trinity Dr
Novato, CA 949475246
(415) 320-2313

Credentials & registration

NPPES · NUCC
NPI registered
August 2022 — 4 yrs on file
Profile last updated
December 5, 2022
Specialty taxonomy
363A00000X — NUCC code
State license (1)
California #61808

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1104546969. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
20
Distinct HCPCS
1
Medicare allowed
$2,936
HCPCS Description Services Patients Avg allowed
99285 Emergency department visit with high level of medical decision making 20 20 $147

In context: peer comparison

Among 3 peers in Novato Physician Assistant, average services per provider: 346. This provider delivers 0.1× the peer median.

Frequently asked questions

Auto-generated from federal data
What is Dr. Theodore Phan's medical specialty?
Dr. Theodore Phan practices Physician Assistant in Novato, CA.
Where does Dr. Theodore Phan practice?
Dr. Theodore Phan practices at 52 Trinity Dr, Novato, CA 949475246. Office phone: 4153202313.
What is Dr. Theodore Phan's NPI?
Dr. Theodore Phan's National Provider Identifier (NPI) is 1104546969, issued by NPPES.
What procedures does Dr. Theodore Phan commonly perform?
Top Medicare-reported procedures in 2023: Emergency department visit with high level of medical decision making (HCPCS 99285). Source: CMS Medicare Physician & Other Practitioners file.