Individual provider Active NPI

Van Thanh Nguyen, DO

  • Obstetrics & Gynecology Physician
  • Santa Ana, CA
National Provider Identifier
1205845237
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A 6915 Issued in CA
Practice address
3501 S Harbor Blvd
Santa Ana, CA 92704-6919
Phone
(714) 929-2300
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39874 CO
Obstetrics & Gynecology Physician 207V00000X 20A 6915 CA Primary

Addresses

Primary practice location

3501 S Harbor Blvd
Santa Ana, CA 92704-6919

Mailing address

3501 S Harbor Blvd
Santa Ana, CA 92704-6919
Phone (714) 929-2300

Other identifiers 1

IdentifierTypeStateIssuer
85729558MedicaidCO

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
I20110228000427 CA Practitioner - Obstetrics/Gynecology 9335190065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Wellness Centers USAGroup PAC ID 1759665367, 30 clinicians

Practice addresses (Care Compare)

1360 E Anaheim St
Long Beach, CA 90813-5514

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A 6915CAMDObstetrics & Gynecology Physician
6915CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Roads Foundation, Inc. CurrentSince Aug 15, 2022 Accepting new patients
Community Medical Wellness Centers USA CurrentSince Nov 7, 2024 Accepting new patients
Community Medical Wellness Centers USA CurrentSince Nov 7, 2024 Accepting new patients

Locations

121 S Long Beach Blvd
Compton, CA 90221
Phone (310) 627-5850

4800 E Los Coyotes Diagonal
Long Beach, CA 90815
Phone (310) 627-5850

1360 E Anaheim St
Ste 101
Long Beach, CA 90813
Phone (562) 270-0324

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD
  • Direct secure messaging: vannguyen@hcpca.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1205845237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 S HARBOR BLVD",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046919",
            "telephone_number": "714-929-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S HARBOR BLVD",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046919",
            "telephone_number": "714-929-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VAN",
        "middle_name": "THANH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "39874",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A 6915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85729558",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.