Individual provider Active NPI

Hiep Nguyen, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1184716151
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A52455 Issued in CA
Practice address
4419 Euclid Ave Ste 105
San Diego, CA 92115-4564
Phone
(619) 582-2079
Fax
(619) 582-2075
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A52455 CA Primary

Addresses

Primary practice location

4419 Euclid Ave Ste 105
San Diego, CA 92115-4564

Mailing address

PO Box 15759
San Diego, CA 92175-5759
Phone (619) 582-2079

Other identifiers 1

IdentifierTypeStateIssuer
00A524550MedicaidCA

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
I20110311000305 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 0345422390 Practice locations: Chula Vista, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52455CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Health, Inc. Past Accepting new patients
Hiep Thanh Nguyen M D Inc Internal Medicine PastSince Sep 21, 2010 Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1184716151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15759",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921755759",
            "telephone_number": "619-582-2079",
            "fax_number": "619-582-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 EUCLID AVE STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154564",
            "telephone_number": "619-582-2079",
            "fax_number": "619-582-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HIEP",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A524550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.