Individual provider Active NPI

Michelle Tu Anh Nguyen, MD

  • Maternal & Fetal Medicine Physician
  • San Diego, CA
National Provider Identifier
1104364017
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
A151127 Issued in CA
Practice address
3750 Convoy St Ste 200
San Diego, CA 92111-3770
Phone
(858) 794-7700
Fax
(858) 794-7744
NPI assigned
Feb 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X A151127 CA Primary

Addresses

Primary practice location

3750 Convoy St Ste 200
San Diego, CA 92111-3770

Mailing address

3750 Convoy St Ste 200
San Diego, CA 92111-3770
Phone (858) 794-7700

Other practice location 1

3003 Health Center Dr
San Diego, CA 92123-2700
Phone (858) 939-3400

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
I20231101000516 CA Practitioner - Obstetrics/Gynecology 4880040534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Baylor College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Obstetrics of San DiegoGroup PAC ID 6608911482, 4 clinicians

Practice addresses (Care Compare)

12264 El Camino Real
Suite 204
San Diego, CA 92130-3061
Phone (858) 794-7700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151127CAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 3, 2023 Accepting new patients
Specialty Obstetrics of San Diego Maternal & Fetal Medicine CurrentSince Sep 19, 2023 Accepting new patients

Locations

12264 El Camino Real
Ste 204
San Diego, CA 92130
Phone (858) 791-7700

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

3750 Convoy St
Ste 200
San Diego, CA 92111
Phone (858) 794-7700

3003 Health Center Dr
San Diego, CA 92123
Phone (858) 939-4185

Interoperability endpoints

  • Direct secure messaging: mnn765pcs@m1146.primeclinicalsystems.direct-ci.com

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": "1486771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1104364017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113770",
            "telephone_number": "858-794-7700",
            "fax_number": "858-794-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113770",
            "telephone_number": "858-794-7700",
            "fax_number": "858-794-7744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921232700",
            "country_code": "US",
            "telephone_number": "858-939-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MICHELLE",
        "middle_name": "TU ANH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-11",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "A151127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.