Elite Atlantic Foot & Ankle Clinic

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

Legal business name

ELITE ATLANTIC FOOT & ANKLE CLINIC

Practice address

925 S Atlantic Blvd Ste 102
Monterey Park, CA 91754-1063

Phone

(714) 638-2653

NPI assigned

Apr 27, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kelvin NguyenNPI 1285957639

Title

President

Phone

(714) 638-2653

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelvin Huy Tang Nguyen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Garden Grove, CA
  • NPI 1285957639
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1265053672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13310 EUCLID ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432514",
            "telephone_number": "714-638-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S ATLANTIC BLVD STE 102",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541063",
            "telephone_number": "714-638-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ATLANTIC FOOT & ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KELVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-638-2653",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastside Orthopedic Medical Associates
• Edmond Lee DPM, Inc.
• Edward Chen Perinatology Corp
• Edward Z Xu Medical Inc
• Jordan Lavell Edwards
• Elite Diagnostic and Medical Group
• Emotional Health Association Share
• Employee Health Systems Medical Group
• En M Lai D.O. Inc
• Rommel Endozo

• Foot Surgery Podiatrist in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Foot Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.