Individual provider Active NPI

Tan Ba Nguyen, M.D.

  • Diagnostic Radiology Physician
  • Anaheim, CA
National Provider Identifier
1053668608
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A130215 Issued in CA
Practice address
5528 E la Palma Ave Ste 4a
Anaheim, CA 92807-2115
Phone
(714) 970-0200
NPI assigned
Aug 13, 2012
Last updated
Sep 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A130215 CA Primary

Addresses

Primary practice location

5528 E la Palma Ave Ste 4a
Anaheim, CA 92807-2115

Mailing address

5528 E la Palma Ave Ste 4a
Anaheim, CA 92807-2115
Phone (714) 970-0200

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
I20170721001538 CA Practitioner - Diagnostic Radiology 7810204799 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Geffen School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David C P Chen, M.D., IncGroup PAC ID 0941196422, 18 clinicians
Fullerton Radiology Medical Group IncGroup PAC ID 4587632575, 55 clinicians
United Premier Physicians IncGroup PAC ID 8527459528, 9 clinicians

Practice addresses (Care Compare)

1129 S San Gabriel Blvd
San Gabriel, CA 91776-3114
Phone (626) 287-6746

1350 W Covina Blvd
San Dimas, CA 91773-3245
Phone (909) 599-6811

27401 Los Altos
Suite 150
Mission Viejo, CA 92691-8013
Phone (949) 367-1010

312 N Garfield Ave
Monterey Park, CA 91754-1707
Phone (626) 572-2889

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
130215CAMDClinical Social Worker
A130215CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Ucsd Department of Radiology Diagnostic Radiology CurrentSince May 28, 2017 Accepting new patients
David C P Chen, M.D., Inc CurrentSince Nov 30, 2024 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince May 28, 2017 Accepting new patients
Crown Valley Radiologists Inc a Professional Medical Corp Diagnostic Radiology CurrentSince Jun 10, 2020 Accepting new patients
United Premier Physicians Inc Diagnostic Radiology CurrentSince Jan 17, 2022 Accepting new patients
Fullerton Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Aug 1, 2018 Accepting new patients
C J Calvin Yang, M D a Professional Corp Diagnostic Radiology CurrentSince Jan 17, 2022 Accepting new patients
Crown Valley Radiologist PastSince Jun 10, 2020 Accepting new patients
Usc University Hospital, Inc. PastSince Nov 30, 2024 Accepting new patients
Scripps Health Past Accepting new patients

Locations

235 S Garfield Ave
Alhambra, CA 91801
Phone (626) 943-9985

320 S Garfield Ave
Ste 102
Alhambra, CA 91801
Phone (626) 281-0124

5528 E La Palma Ave
Ste 4A
Anaheim, CA 92807
Phone (714) 970-0200

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

27401 Los Altos
Ste 150
Mission Viejo, CA 92691
Phone (949) 209-9008

27401 Los Altos
Ste 180
Mission Viejo, CA 92691
Phone (949) 582-9624

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

208 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 287-6746

312 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 572-2889

4501 Birch St
Ste C
Newport Beach, CA 92660
Phone (310) 208-3100

4501 Birch St
Unit C
Newport Beach, CA 92660
Phone (949) 367-1010

1301 N Rose Dr
Placentia, CA 92870
Phone (714) 524-4252

1325 N Rose Dr
Placentia, CA 92870
Phone (714) 628-1313

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

8929 University Center Ln
Ste 101
San Diego, CA 92122
Phone (858) 457-4227

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

1129 S San Gabriel Blvd
San Gabriel, CA 91776
Phone (626) 282-2802

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1053668608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 E LA PALMA AVE STE 4A",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072115",
            "telephone_number": "714-970-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5528 E LA PALMA AVE STE 4A",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072115",
            "telephone_number": "714-970-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAN",
        "middle_name": "BA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A130215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.