Individual provider Active NPI

Michael John Nguyen, MD

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1093930612
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A101319 Issued in CA
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-3075
Phone
(310) 301-6800
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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 A101319 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-3075

Mailing address

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-6800

Other identifiers 1

IdentifierTypeStateIssuer
0A1013190MedicaidCA

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
I20110606000439 CA Practitioner - Diagnostic Radiology 2567649221 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101319CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Dec 18, 2017 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Dec 18, 2017 Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

123 W Manchester Blvd
Inglewood, CA 90301
Phone (310) 419-5325

335 E Avenue I
Lancaster, CA 93535
Phone (661) 471-4000

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1093930612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-301-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A101319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1013190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.