Active NPI
Elizabeth Nguyen
- Physician Assistant
- Costa Mesa, CA
National Provider Identifier
1275091183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 56607
- Practice address
- 1520 Nutmeg PL Ste 101
Costa Mesa, CA 92626-2557 - Phone
- (714) 922-4100
- NPI assigned
- Mar 10, 2019
- Last updated
- Jul 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 56607 | CA | Primary |
Addresses
Primary practice location
1520 Nutmeg PL Ste 101
Costa Mesa, CA 92626-2557
Mailing address
11160 Warner Ave
Fountain Valley, CA 92708-4008
Phone (714) 424-9300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56607 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood/Orange and San Bernardino Counties, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Melody Health
- Clinic/Center
- Anaheim, CA
- NPI 1710975727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1275091183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11160 WARNER AVE",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927084008",
"telephone_number": "714-424-9300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 NUTMEG PL STE 101",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926262557",
"telephone_number": "714-922-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-10",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "56607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.