Individual provider Active NPI

Joe Nguyen, SCALP MICROPIGMENTAT

  • Prosthetics Case Management
  • San Leandro, CA
National Provider Identifier
1063979136
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
1515 Aurora Dr Ste 102B
San Leandro, CA 94577-3105
Phone
(510) 258-9543
NPI assigned
Feb 26, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X Primary

Addresses

Primary practice location

1515 Aurora Dr Ste 102B
San Leandro, CA 94577-3105

Mailing address

1515 Aurora Dr Ste 102B
San Leandro, CA 94577-3105
Phone (510) 258-9543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1063979136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 AURORA DR STE 102B",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945773105",
            "telephone_number": "510-258-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 AURORA DR STE 102B",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945773105",
            "telephone_number": "510-258-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOE",
        "credential": "SCALP MICROPIGMENTAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.