Individual provider Active NPI

Anthony Nguyen, MD

  • Pediatrics Physician
  • Eastvale, CA
National Provider Identifier
1285042929
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A130483 Issued in CA
Practice address
12742 Limonite Ave
Eastvale, CA 92880-9630
Phone
(951) 739-2750
Fax
(951) 371-6587
NPI assigned
Jul 25, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A130483 CA Primary

Addresses

Primary practice location

12742 Limonite Ave
Eastvale, CA 92880-9630

Mailing address

12742 Limonite Ave
Eastvale, CA 92880-9630
Phone (951) 739-2750

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
I20151005001117 CA Practitioner - Pediatric Medicine 0840508214 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
130483CAMDMarriage & Family Therapist
A130483CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Current Accepting new patients
Riverside Medical Clinic, Inc Pediatrics CurrentSince Jul 13, 2015 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients

Locations

12742 Limonite Ave
Eastvale, CA 92880
Phone (951) 739-2712

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

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": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1285042929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12742 LIMONITE AVE",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928809630",
            "telephone_number": "951-739-2750",
            "fax_number": "951-371-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12742 LIMONITE AVE",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928809630",
            "telephone_number": "951-739-2750",
            "fax_number": "951-371-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-25",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A130483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastvale, CA

Sources for this page

Verify at the official NPI Registry.