Individual provider Active NPI

Clamon Quang Vu, M.D.

  • Family Medicine Physician
  • Huntington Beach, CA
National Provider Identifier
1144554411
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A109331 Issued in CA
Practice address
17762 Beach Blvd
Suite 100
Huntington Beach, CA 92647-6860
Phone
(714) 848-0080
NPI assigned
Sep 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A109331 CA Primary

Addresses

Primary practice location

17762 Beach Blvd
Suite 100
Huntington Beach, CA 92647-6860

Mailing address

17762 Beach Blvd
Suite 100
Huntington Beach, CA 92647-6860

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
I20110927000328 CA Practitioner - Family Practice 8325219140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

9122 Adams Ave
Huntington Beach, CA 92646-3405
Phone (714) 378-0900

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109331CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Sep 1, 2011 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine PastSince Sep 1, 2011 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

18561 Beach Blvd
Huntington Beach, CA 92648
Phone (714) 848-0080

17762 Beach Blvd
Ste 100
Huntington Beach, CA 92647
Phone (714) 848-0080

17762 Beach Blvd
Ste 220
Huntington Beach, CA 92647
Phone (714) 848-0080

9122 Adams Ave
Huntington Beach, CA 92646
Phone (714) 378-0900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cvu182451@direct.memorialcare.org

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": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1144554411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17762 BEACH BLVD",
            "address_2": "SUITE 100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17762 BEACH BLVD",
            "address_2": "SUITE 100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476860",
            "telephone_number": "714-848-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "CLAMON",
        "middle_name": "QUANG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-18",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A109331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.