Individual provider Active NPI

Annmarie Trang Nguyen, MD

  • Medical Specialty Clinic/Center
  • Garden Grove, CA
National Provider Identifier
1083628036
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
G69150 Issued in CA
Practice address
12665 Garden Grove Blvd
Suite 611
Garden Grove, CA 92843-1901
Phone
(714) 539-5225
Fax
(714) 539-5213
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G69150 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd
Suite 611
Garden Grove, CA 92843-1901

Mailing address

12665 Garden Grove Blvd Ste 611
Garden Grove, CA 92843-1920
Phone (714) 539-5225

Other identifiers 2

IdentifierTypeStateIssuer
BI 909OtherCAMEDICARE ID
00G691500MedicaidCA

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
I20051108000576 CA Practitioner - Obstetrics/Gynecology 0749208700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Hahnemann University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12665 Garden Grove Blvd
Suite 611
Garden Grove, CA 92843-1920
Phone (714) 539-5225

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69150CAMDMedical Specialty Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital of Orange PastSince Jul 16, 2008 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1083628036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 611",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431920",
            "telephone_number": "714-539-5225",
            "fax_number": "714-539-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 611",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-539-5225",
            "fax_number": "714-539-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANNMARIE",
        "middle_name": "TRANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G69150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "BI 909",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G691500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.