Individual provider Active NPI

Quy Van Nguyen, MD

  • Internal Medicine Physician
  • Rosemead, CA
National Provider Identifier
1366400145
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A44652 Issued in CA
Practice address
9126 Valley Blvd
Suite B
Rosemead, CA 91770-1987
Phone
(626) 573-9003
Fax
(626) 573-0641
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A44652 CA Primary

Addresses

Primary practice location

9126 Valley Blvd
Suite B
Rosemead, CA 91770-1987

Mailing address

9126 Valley Blvd
Suite B
Rosemead, CA 91770-1987
Phone (626) 573-9003

Other identifiers 1

IdentifierTypeStateIssuer
00A446520MedicaidCA

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
I20040212000755 CA Practitioner - Internal Medicine 3274427810 Reassigns benefits to 1 organization
Practice locations: Rosemead, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44652CAMDGeneral Practice Dentistry
A44652CAMDInternal Medicine Physician

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1366400145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9126 VALLEY BLVD",
            "address_2": "SUITE B",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917701987",
            "telephone_number": "626-573-9003",
            "fax_number": "626-573-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9126 VALLEY BLVD",
            "address_2": "SUITE B",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917701987",
            "telephone_number": "626-573-9003",
            "fax_number": "626-573-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "QUY",
        "middle_name": "VAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A44652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A446520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemead, CA

Sources for this page

Verify at the official NPI Registry.