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Mesa Advantage Medical Group

Exclusive Provider Organization in San Marino, CA · enumerated 2016 · authorized official Lan Phan, Ceo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1578017778

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Registry record

Entity type Organization (Type 2)
Legal business name Mesa Advantage Medical Group
Practice address 2295 Huntington Dr # D, San Marino, CA, 91108
Phone (626) 656-2370
Fax (626) 248-9060
Enumeration date Aug 5, 2016
Last updated in NPPES Jul 21, 2022

Taxonomy & classification

302F00000X Exclusive Provider Organization Managed Care Organizations · License A (CA) Secondary
302F00000X Exclusive Provider Organization Managed Care Organizations Primary

Authorized official

Name Lan Phan
Title Ceo
Phone (818) 399-8996

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Mesa Advantage Medical Group?
Mesa Advantage Medical Group is registered in NPPES as a Exclusive Provider Organization (its primary provider taxonomy).

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-07-21.