Individual provider Active NPI

Nancy Tien Vo, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1083978506
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4733 W Sunset Blvd
3Rd Floor
Los Angeles, CA 90027-6021
Phone
(714) 886-8539
NPI assigned
Jun 29, 2012
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X D9972773 CA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4733 W Sunset Blvd
3Rd Floor
Los Angeles, CA 90027-6021

Mailing address

4733 W Sunset Blvd
3Rd Floor
Los Angeles, CA 90027-6021
Phone (714) 886-8539

Other identifiers 1

IdentifierTypeStateIssuer
XDMI188A56421OtherCAANTHEM BLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20191030003146 CA Practitioner - Family PracticePractitioner - Geriatric Medicine 5698015543 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D9972773CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 16, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 16, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince May 14, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4733 W Sunset Blvd
Fl 3
Los Angeles, CA 90027
Phone (323) 783-1431

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 5

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1083978506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 W SUNSET BLVD",
            "address_2": "3RD FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276021",
            "telephone_number": "714-886-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4733 W SUNSET BLVD",
            "address_2": "3RD FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276021",
            "telephone_number": "714-886-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "NANCY",
        "middle_name": "TIEN",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "D9972773",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "XDMI188A56421",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.