NPIMap

Individual provider Active NPI

Albert Phan Nguyen, MD

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1134359094
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A123135 Issued in CA
Practice address
200 W Arbor Dr
Department of Anesthesiology
San Diego, CA 92103-9000
Phone
(858) 657-7000
NPI assigned
Jul 24, 2009
Last updated
Nov 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A123135 CA Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X A123135 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A123135 CA

Addresses

Primary practice location

200 W Arbor Dr
Department of Anesthesiology
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 303-1709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140828000032 CA Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 4385862655 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Critical Care (Intensivists)
Education
University of Colorado School of Medicine, Denver, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123135CAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince Mar 1, 2015 Accepting new patients
Regents of the University of California Anesthesiology CurrentSince Jul 12, 2014 Accepting new patients
Regents of the University of California Pain Medicine Current Accepting new patients
Providence Medical Foundation CurrentSince Nov 19, 2018 Accepting new patients
Regents of the University of California CurrentSince Jul 12, 2014 Accepting new patients
Providence Medical Foundation CurrentSince Nov 19, 2018 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Regents of the University of California Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

35900 Bob Hope Dr
Ste 257
Rancho Mirage, CA 92270
Phone (760) 321-2500

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

Organizations & group practices 10

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1134359094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "858-657-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 Montgomery Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954054801",
            "country_code": "US",
            "telephone_number": "707-303-1709",
            "fax_number": "707-303-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ALBERT",
        "middle_name": "PHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A123135",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A123135",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A123135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.