Active NPI
Kristine Kim Nguyen
- Pediatrics Physician
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A21711
- Practice address
- 11234 Anderson St
Loma Linda, CA 92354-2804 - Phone
- (909) 558-4174
- NPI assigned
- Aug 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A21711 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Loma Linda, CA 92354-2804
Mailing address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-4174
Other practice location 1
9862 Chapman Ave
Suite B
Garden Grove, CA 92841-2726
Phone (714) 640-3470
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7223 Church St
Suite C1
Highland, CA 92346-5869
Phone (909) 425-3946
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A21711 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Sac Health System | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Pediatrics | Current | Accepting new patients |
| Sac Health System | Current | Accepting new patients | |
| Sac Health System | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients |
Locations
7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946
82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733
11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174
250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990
1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146
Interoperability endpoints
- knguyen371973@direct.llu.edu
Organizations & group practices 8
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Apple Valley, CA
- NPI 1205009917
-
dba SAC Arrowhead
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1013935923
-
- Neurological Surgery Physician
- Loma Linda, CA
- NPI 1194775122
-
- Obstetrics & Gynecology Physician
- Rancho Cucamonga, CA
- NPI 1568113827
-
- Pediatrics Physician
- Highland, CA
- NPI 1689624991
-
dba SAC Indio CVRM Manila
- Federally Qualified Health Center (FQHC)
- Indio, CA
- NPI 1386299204
-
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1467274126
-
- Orthopaedic Surgery Physician
- Loma Linda, CA
- NPI 1275582918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1154876381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-4174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-4174"
}
],
"practiceLocations": [
{
"address_1": "9862 Chapman Ave",
"address_2": "Suite B",
"address_purpose": "LOCATION",
"city": "Garden Grove",
"state": "CA",
"postal_code": "928412726",
"country_code": "US",
"telephone_number": "714-640-3470",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "KRISTINE",
"middle_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-17",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A21711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.