Individual provider Active NPI

Than Nguyen, D.O.

  • Internal Medicine Physician
  • Berkeley, CA
National Provider Identifier
1316207236
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L2226995 Issued in MI
Practice address
2850 Telegraph Ave Ste 130
Berkeley, CA 94705-1159
Phone
(510) 204-8120
Fax
(510) 506-7721
NPI assigned
May 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 20A15824 CA
Internal Medicine Physician 207R00000X L2226995 MI Primary

Addresses

Primary practice location

2850 Telegraph Ave Ste 130
Berkeley, CA 94705-1159

Mailing address

28050 Grand River Ave
Farmington Hills, MI 48336-5919

Other practice location 1

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (248) 471-8224

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20190122000929 CA Practitioner - Internal Medicine 5698068583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

20101 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 886-3400

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 727-3256

2450 Ashby Ave
Berkeley, CA 94705-2067
Phone (510) 204-4444

2850 Telegraph Ave
Berkeley, CA 94705-1159

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

350 Hawthorne Ave
Oakland, CA 94609-3108
Phone (510) 655-4000

Hospital & facility affiliations

  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy31
Upper gastrointestinal (GI) endoscopy for acid reflux61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15824CAMDProfessional Counselor
L2226995MIMDInternal Medicine Physician
20A15824CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Oct 9, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 14, 2025 Accepting new patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 14, 2025 Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Oct 9, 2018 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Sutter East Bay Medical Foundation Internal Medicine Past Accepting new patients

Locations (25 of 33)

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2850 Telegraph Ave
Ste 130
Berkeley, CA 94705
Phone (510) 204-8110

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

12 Camino Encinas
Fl 1
Orinda, CA 94563
Phone (510) 410-3524

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

Interoperability endpoints

  • Direct secure messaging: tnguyen735399@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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 3

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1316207236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28050 GRAND RIVER AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 TELEGRAPH AVE STE 130",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051159",
            "telephone_number": "510-204-8120",
            "fax_number": "510-506-7721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "248-471-8224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "20A15824",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "L2226995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "One Quality Drive",
            "city": "Vacaville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.