Anh Tam Nguyen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101253929 Issued in VA

Practice address

BLDG 30, 2400 S Pacific Ave
San Pedro, CA 90731

Phone

(310) 653-8668

NPI assigned

Jun 16, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1194046813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 30, 2400 S PACIFIC AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 30, 2400 S PACIFIC AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90731",
            "telephone_number": "310-653-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANH",
        "middle_name": "TAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116022588",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101253929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Line Anesthesia Services, Inc.
• Newport Care Medical Group Inc
• Nguyen Procare Chiropractic Inc
• Adeline H Nguyen, DDS
• Angela Thylan Nguyen, PHARMD
• Christina Hoanglan Nguyen, PHARMD
• Chuong Duy Nguyen
• Linh Nguyen, D.D.S.
• Silverton Nguyen, PT
• Son Lam Nguyen, D.C, L.AC

• Family Medicine Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.