Individual provider Active NPI

Tung Cong Nguyen, D.O.

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1285679449
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5784 Issued in CA
Practice address
2509 W 1St St
Santa Ana, CA 92703-3401
Phone
(714) 541-0057
Fax
(714) 541-0047
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A5784 CA Primary

Addresses

Primary practice location

2509 W 1St St
Santa Ana, CA 92703-3401

Mailing address

PO Box 9869
Fountain Valley, CA 92728-9869
Phone (714) 697-7735

Other identifiers 1

IdentifierTypeStateIssuer
OOAX57840MedicaidCA

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
I20110405000289 CA Practitioner - Family Practice 0345424073 Reassigns benefits to 1 organization
Practice locations: Santa Ana, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Choice Aco IncGroup PAC ID 7719379395, 60 clinicians

Practice addresses (Care Compare)

2509 W 1St St
Santa Ana, CA 92703-3401
Phone (714) 541-0057

7631 Wyoming St
Suite 201
Westminster, CA 92683-3904

Hospital & facility affiliations

  • Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A5784CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Choice Aco Inc CurrentSince Nov 10, 2021 Accepting new patients

Locations

7631 Wyoming St
Ste 201
Westminster, CA 92683
Phone (714) 898-0765

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1285679449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9869",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927289869",
            "telephone_number": "714-697-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 W 1ST ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927033401",
            "telephone_number": "714-541-0057",
            "fax_number": "714-541-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TUNG",
        "middle_name": "CONG",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOAX57840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.