Individual provider Active NPI

Vinh Tran Nguyen, MD

  • Pediatric Allergy/Immunology Physician
  • San Bernardino, CA
National Provider Identifier
1295231868
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
A196733 Issued in CA
Practice address
250 E Caroline St
San Bernardino, CA 92408-3747
Phone
(909) 651-1900
NPI assigned
Apr 3, 2018
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X TL0009292 CO
Pediatrics Physician 208000000X 63026 AZ
Pediatric Allergy/Immunology Physician 2080P0201X A196733 CA Primary

Addresses

Primary practice location

250 E Caroline St
San Bernardino, CA 92408-3747

Mailing address

2038 Kenton St
Aurora, CO 80010-1310
Phone (703) 395-7129

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
I20240918000844 CA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 7911305453 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL0009292COMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics CurrentSince Oct 16, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

Interoperability endpoints

  • Direct secure messaging: vnguyen1229480@direct.llu.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1295231868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2038 KENTON ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800101310",
            "telephone_number": "703-395-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E CAROLINE ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083747",
            "telephone_number": "909-651-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VINH",
        "middle_name": "TRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CO",
            "license": "TL0009292",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "63026",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "CA",
            "license": "A196733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.