Active NPI
Brian L Nguyen MD, Inc
- Cardiovascular Disease Physician
- Sun City, CA
National Provider Identifier
1346305166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- A53427
- Legal business name
- BRIAN L NGUYEN MD, INC
- Practice address
- 29798 Haun Road
Suite 108
Sun City, CA 92586-6541 - Phone
- (951) 301-9339
- Fax
- (951) 301-3980
- NPI assigned
- Dec 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brian L Nguyen, MD
- Title
- MD/Owner
- Phone
- (951) 301-9339
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | A53427 | CA | Primary |
Addresses
Primary practice location
29798 Haun Road
Suite 108
Sun City, CA 92586-6541
Mailing address
PO Box 991
Sun City, CA 92586-0991
Phone (951) 301-9339
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110219240 | Other | RAILROAD MEDICARE | |
| DN6409 | Other | CA | RAILROAD MEDICARE |
| 00A534271 | Other | CA | MEDICARE NHIC 31565 RANCHO PUEBLO STE 102 TEMECULA CA 92592 |
| 00A534271 | Medicaid | CA | |
| 00A534270 | Other | CA | 31565 RANCHO PUEBLE STE 102 TEMECULA, CA 92592 MEDICARE NHIC |
| G64785 | Medicaid | CA | |
| 00A534270 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080130000518 | CA | Part B Supplier - Clinic/Group Practice | 9032291968 |
Receives reassigned benefits from 5 practitioners Practice locations: Sun City, CA; Temecula, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0984303 | Brian L Nguyen MD Inc | Certificate of waiver | Mar 18, 2027 |
National Provider Directory
National Provider DirectoryLocations
29798 Haun Rd
Ste SB137
Sun City, CA 92586
31565 Rancho Pueblo Rd
Ste 1
Temecula, CA 92592
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1334880000000",
"number": "1346305166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 991",
"city": "SUN CITY",
"state": "CA",
"postal_code": "925860991",
"telephone_number": "951-301-9339",
"fax_number": "951-301-3980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29798 HAUN ROAD",
"address_2": "SUITE 108",
"city": "SUN CITY",
"state": "CA",
"postal_code": "925866541",
"telephone_number": "951-301-9339",
"fax_number": "951-301-3980"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIAN L NGUYEN MD, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-22",
"last_updated": "2012-04-20",
"status": "A",
"authorized_official_last_name": "NGUYEN",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "MD/OWNER",
"authorized_official_telephone_number": "951-301-9339",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "A53427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110219240",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DN6409",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NHIC 31565 RANCHO PUEBLO STE 102 TEMECULA CA 92592",
"identifier": "00A534271",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A534271",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "31565 RANCHO PUEBLE STE 102 TEMECULA, CA 92592 MEDICARE NHIC",
"identifier": "00A534270",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G64785",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A534270",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sun City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.