Active NPI
Khoa Dang Nguyen, MD
- Family Medicine Physician
- Mission Hills, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A61182
- Practice address
- 11333 Sepulveda Blvd
Mission Hills, CA 91345-1116 - Phone
- (818) 365-9531
- NPI assigned
- Jul 31, 2006
- Last updated
- May 29, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A61182 | CA | Primary |
Addresses
Primary practice location
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Mailing address
PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559
Other practice location 1
9122 Adams Ave
Huntington Beach, CA 92646-3405
Phone (714) 378-0900
Other practice location 2
9122 Adams Ave
Huntington Beach, CA 92646-3405
Phone (714) 378-0900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A611820 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
- Family Practice
- Education
- University of California, Geffen School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011
1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A61182 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Providence Facey Medical Foundation | Past | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Clinic/Center
- Fountain Valley, CA
- NPI 1205167350
-
dba Facey Endoscopy Center
- Ambulatory Surgical Clinic/Center
- Mission Hills, CA
- NPI 1194083824
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kaiser Foundation Hospital - Baldwin Park
- General Acute Care Hospital
- Baldwin Park, CA
- NPI 1477608271
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716940800000",
"number": "1164438172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9602",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913469602",
"telephone_number": "818-837-5559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11333 SEPULVEDA BLVD",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913451116",
"telephone_number": "818-365-9531"
}
],
"practiceLocations": [
{
"address_1": "9122 Adams Ave",
"address_purpose": "LOCATION",
"city": "Huntington Beach",
"state": "CA",
"postal_code": "926463405",
"country_code": "US",
"telephone_number": "714-378-0900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9122 Adams Ave",
"address_purpose": "LOCATION",
"city": "Huntington Beach",
"state": "CA",
"postal_code": "926463405",
"country_code": "US",
"telephone_number": "714-378-0900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "KHOA",
"middle_name": "DANG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2024-05-29",
"certification_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A61182",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A611820",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1011 Baldwin Park Blvd",
"city": "Baldwin Park",
"state": "CA",
"country_code": "US",
"postal_code": "917065806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mission Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.