Individual provider Active NPI

Jonathan Tuan Nguyen

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1023193125
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A73239 Issued in CA
Practice address
555 East Pacific Coast Hwy
Ste #102
Long Beach, CA 90806
Phone
(562) 591-3222
Fax
(562) 591-3390
NPI assigned
Oct 26, 2006
Last updated
Jul 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A73239 CA Primary

Addresses

Primary practice location

555 East Pacific Coast Hwy
Ste #102
Long Beach, CA 90806

Mailing address

555 East Pacific Coast Hwy
Ste #102
Long Beach, CA 90806
Phone (562) 591-3222

Other identifiers 2

IdentifierTypeStateIssuer
9491235OtherPIN NUMBER
00A732390MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050524000660 CA Practitioner - Internal MedicinePractitioner - Other (Physician) 1951343524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Chicago College of Medicine and Surgery, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

555 E Pacific Coast Hwy
Suite 102
Long Beach, CA 90806-5579
Phone (562) 591-3222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73239CAMDPharmacist
A73239CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Nguyen Medical Clinic Inc Internal Medicine CurrentSince Oct 30, 2019 Accepting new patients
Jonathan T Nguyen M.D Inc Internal Medicine CurrentSince Jan 5, 2005 Accepting new patients
Bao Quoc Le MD. Inc PastSince Apr 13, 2015 Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Nova Care Clinic, Inc PastSince Apr 6, 2026 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
SD Medical Clinic Inc, a Professional Corporation Internal Medicine PastSince Aug 5, 2009 Accepting new patients

Locations

555 E Pacific Coast Hwy
#1
Long Beach, CA 90806

555 E Pacific Coast Hwy
Ste 102
Long Beach, CA 90806
Phone (562) 591-3222

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1023193125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 EAST PACIFIC COAST HWY",
            "address_2": "STE #102",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-591-3222",
            "fax_number": "562-591-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 EAST PACIFIC COAST HWY",
            "address_2": "STE #102",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-591-3222",
            "fax_number": "562-591-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JONATHAN",
        "middle_name": "TUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A73239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN NUMBER",
            "identifier": "9491235",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A732390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.