Individual provider Active NPI

Duc Tien Nguyen, D.P.M, D.C

  • Primary Podiatric Medicine Podiatrist
  • Garden Grove, CA
National Provider Identifier
1245495498
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
E4494 Issued in CA
Practice address
9355 Chapman Ave Ste 202
Garden Grove, CA 92841-2536
Phone
(818) 925-0193
NPI assigned
Jul 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X E4494 CA Primary
Chiropractor 111N00000X 21758 CA

Addresses

Primary practice location

9355 Chapman Ave Ste 202
Garden Grove, CA 92841-2536

Mailing address

14441 Beach Blvd 225
Westminster, CA 92683-5347
Phone (818) 925-0193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090401000458 CA Practitioner - ChiropracticPractitioner - Podiatry 8527115815 Reassigns benefits to 1 organization
I20160222000135 CA Practitioner - Podiatry 8527115815 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Podiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy MD Medical Group IncGroup PAC ID 0446619738, 12 clinicians
Convalescent Podiatry Care a Professional CorporationGroup PAC ID 7315470036, 5 clinicians

Practice addresses (Care Compare)

1520 S Imperial Ave
El Centro, CA 92243-4241
Phone (760) 550-1685

1699 N Imperial Ave
El Centro, CA 92243-1320
Phone (760) 352-2551

222 E Cole Blvd
Calexico, CA 92231-3211
Phone (760) 550-1685

5445 Del Amo Blvd
Suite 102
Lakewood, CA 90712-2761
Phone (562) 867-0811

690 Otay Lakes Rd
Suite 120
Chula Vista, CA 91910-8904
Phone (760) 352-2551

81812 Dr Carreon Blvd
Suite E
Indio, CA 92201-5594
Phone (760) 352-2551

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue57
Removal of skin lesions1-10
Removal of nail tissue6022
Removal or shaving of skin growth1060
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4494CAMDPrimary Podiatric Medicine Podiatrist
4494CAMDOccupational Therapist

Practice roles (9 of 10)

OrganizationSpecialtyStatusNew patients
Vo Medical Center CurrentSince Feb 1, 2020 Accepting new patients
Michael D. Kotzen, Inc. CurrentSince Jul 17, 2023 Accepting new patients
Legacy MD Medical Group Inc CurrentSince Oct 1, 2023 Accepting new patients
Imperial Manor Skilled Nursing Inc CurrentSince Aug 10, 2024 Accepting new patients
Convalescent Podiatry Care a Professional Corporation CurrentSince Nov 1, 2024 Accepting new patients
Vo Medical Center CurrentSince Feb 1, 2020 Accepting new patients
James F Eggold Past Accepting new patients
Convalescent Podiatry Care Past Accepting new patients
Legacy MD Medical Group Inc PastSince May 28, 2024 Accepting new patients

Locations

290 Main St
Brawley, CA 92227
Phone (760) 352-2551

222 E Cole Blvd
Calexico, CA 92231
Phone (760) 352-2551

222 E Cole Blvd
Ste C
Calexico, CA 92231
Phone (760) 352-2551

690 Otay Lakes Rd
Ste 125
Chula Vista, CA 91910
Phone (760) 352-2551

690 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 421-0444

690 Otay Lakes Rd
Ste 120
Chula Vista, CA 91910
Phone (619) 397-7800

1699 N Imperial Ave
El Centro, CA 92243
Phone (442) 283-3494

1590 S Imperial Ave
El Centro, CA 92243
Phone (760) 352-2551

81812 Doctor Carreon Blvd
Ste E
Indio, CA 92201
Phone (442) 236-1498

5445 Del Amo Blvd
Ste 102
Lakewood, CA 90712
Phone (562) 867-0811

1335 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (562) 867-0811

12520 Magnolia Blvd
Ste 304
Valley Vlg, CA 91607
Phone (818) 452-9902

15243 Vanowen St
Ste 411B
Van Nuys, CA 91405
Phone (818) 408-2800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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": "1217030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1245495498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14441 BEACH BLVD 225",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835347",
            "telephone_number": "818-925-0193",
            "fax_number": "714-551-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9355 CHAPMAN AVE STE 202",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928412536",
            "telephone_number": "818-925-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DUC",
        "middle_name": "TIEN",
        "name_prefix": "Dr.",
        "credential": "D.P.M, D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-26",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E4494",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.