Mesa Advantage Medical Group
NPI 1578017778ActiveOrganization· Exclusive Provider Organization· San Marino, CA
Exclusive Provider Organization in San Marino, California, registered in NPPES in August 2016. The authorized official on file is Lan Nhu Bich Phan, Ceo.
Overview
| NPI | 1578017778 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 5, 2016 |
| Last updated in NPPES | Jul 21, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Exclusive Provider Organization Primary | 302F00000X | — | — |
| Exclusive Provider Organization | 302F00000X | A | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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