Individual provider Active NPI

Nam Khanh Thai, MD

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1194285296
Registry record updated Jul 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A178337 Issued in CA
Practice address
1333 Chestnut Ave
Long Beach, CA 90813-2944
Phone
(562) 753-2302
NPI assigned
Mar 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A178337 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X PTL404 CA

Addresses

Primary practice location

1333 Chestnut Ave
Long Beach, CA 90813-2944

Mailing address

1333 Chestnut Ave
Long Beach, CA 90813-2944
Phone (562) 753-2302

Other practice location 1

10005 Flower St
Bellflower, CA 90706-5473
Phone (562) 526-3099

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
I20251023003531 CA Practitioner - Family Practice 1951732833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

1333 Chestnut Ave
Long Beach, CA 90813-2944
Phone (562) 753-2315

Hospital & facility affiliations

  • Lac/Harbor-UCLA Med Center Hospital, Torrance, CA, CCN 050376
  • Lac/Rancho Los Amigos National Rehabilitation Ctr Hospital, Downey, CA, CCN 050717

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PTL404CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Aug 3, 2025 Accepting new patients
County of Los Angeles CurrentSince Aug 3, 2025 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

10005 Flower St
Bellflower, CA 90706
Phone (310) 518-8803

1108 N Oleander Ave
Compton, CA 90222
Phone (310) 763-2244

1333 Chestnut Ave
Long Beach, CA 90813
Phone (562) 599-8601

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752969600000",
    "number": "1194285296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 CHESTNUT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908132944",
            "telephone_number": "562-753-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 CHESTNUT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908132944",
            "telephone_number": "562-753-2302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10005 Flower St",
            "address_purpose": "LOCATION",
            "city": "Bellflower",
            "state": "CA",
            "postal_code": "907065473",
            "country_code": "US",
            "telephone_number": "562-526-3099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAI",
        "first_name": "NAM",
        "middle_name": "KHANH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-23",
        "last_updated": "2025-07-20",
        "certification_date": "2025-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A178337",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PTL404",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.