Individual provider Active NPI

Lanhuong Thi Nguyen, M.D.

  • Family Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1336104264
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A36628 Issued in CA
Practice address
10402 Westminster Ave
Suite100
Garden Grove, CA 92843-4861
Phone
(714) 539-4900
Fax
(714) 539-4902
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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 A36628 CA Primary

Addresses

Primary practice location

10402 Westminster Ave
Suite100
Garden Grove, CA 92843-4861

Mailing address

10402 Westminster Ave Ste 100
Garden Grove, CA 92843-4862
Phone (714) 539-4900

Other identifiers 1

IdentifierTypeStateIssuer
00A366280MedicaidCA

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
I20090213000086 CA Practitioner - Family Practice 3971668625

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36628CAMDSpecialist
A36628CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thaibinh Phan MD Inc PastSince Jan 19, 1998 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1336104264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10402 WESTMINSTER AVE STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434862",
            "telephone_number": "714-539-4900",
            "fax_number": "714-539-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10402 WESTMINSTER AVE",
            "address_2": "SUITE100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434861",
            "telephone_number": "714-539-4900",
            "fax_number": "714-539-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LANHUONG",
        "middle_name": "THI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A36628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A366280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.