Luan Phu Nguyen, M.D.
Individual provider Active NPI Family Medicine Physician · Tamuning, GU
NPI 1124331160 · NPPES record last updated May 30, 2024
Key facts
- NPI
- 1124331160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M-1898 (GU)
- Practice address
- 1244 N Marine Corps Dr
Tamuning, GU 96913-4308 - Phone
- (671) 647-8262
- Fax
- (671) 647-5252
- NPI assigned
- Jul 20, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- American Medical Center, LLC
Practice addresses (Care Compare)
1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GU
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160419000807 | GU | Practitioner - Family Practice | 5294917217 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-1898 | GU | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | OH | ||
| Family Medicine Physician | 207Q00000X | M-1898 | GU | Yes |
Addresses
Primary practice location
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Mailing address
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Other providers in Tamuning, GU
- Julie S Namm
- Carol Ellen Naumann
- Christopher Henry Nebzydoski
- Ashley Nelson
- Newgen Aesthetics & Wellness, LLC
- Frances Nicdao
- Placido Nicdao II
- Janet E Nightingale
- Marvin Nogoy
- Annah E. Noland
All providers in Tamuning, GU · Family Medicine Physician in Guam
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.