Individual provider Active NPI

Lisa Ngoc Thi Nguyen, DO

  • Family Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1346735156
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17767 Issued in CA
Practice address
7761 Garden Grove Blvd
Garden Grove, CA 92841-4200
Phone
(714) 898-8888
NPI assigned
Jun 25, 2018
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 17767 CA Primary

Addresses

Primary practice location

7761 Garden Grove Blvd
Garden Grove, CA 92841-4200

Mailing address

12342 Harvey LN
Garden Grove, CA 92841-3612

Other practice location 1

147 N. Brent Street
Ventura, CA 93003
Phone (805) 652-5672

Other practice location 2

4943 Slauson Ave
Maywood, CA 90270-3020
Phone (562) 776-5005

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
I20220708003470 CA Practitioner - Family Practice 2860890266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7761 Garden Grove Blvd
Garden Grove, CA 92841-4200
Phone (714) 898-8888

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nhan Hoa Comprenesive Health Care Clinic Inc. CurrentSince Jun 6, 2022 Accepting new patients
Nhan Hoa Comprehensive Health Care Clinic Inc CurrentSince Jun 6, 2022 Accepting new patients

Locations

7761 Garden Grove Blvd
Garden Grove, CA 92841
Phone (714) 898-8888

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1346735156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12342 HARVEY LN",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928413612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7761 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928414200",
            "telephone_number": "714-898-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 N. Brent Street",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "93003",
            "country_code": "US",
            "telephone_number": "805-652-5672",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4943 Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "CA",
            "postal_code": "902703020",
            "country_code": "US",
            "telephone_number": "562-776-5005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LISA",
        "middle_name": "NGOC THI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "17767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.