Khoa Dang Nguyen, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A111239 Issued in CA

Practice address

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305

Phone

(510) 727-3256

Fax

(510) 727-3107

NPI assigned

May 13, 2010

Last updated

Oct 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ashit Jain MD Inc

  dba California Hospitalist Medical Corporation

  • Internal Medicine Physician
  • Fremont, CA
  • NPI 1720098387
  Medicare reassignment NPD

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1386962421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 MT DIABLO BLVD STE 200",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493746",
            "telephone_number": "916-854-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-727-3256",
            "fax_number": "510-727-3107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17095 Main St",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923456004",
            "country_code": "US",
            "telephone_number": "760-241-6666",
            "fax_number": "760-947-5619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHOA",
        "middle_name": "DANG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-13",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A111239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A111239",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khoanguyen@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "17095 Main St",
            "city": "Hesperia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923456004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen Marie Newcomb, MFT
• Anh Phuong Nguyen
• Baotram Nguyen, M.D.
• Cac-Han Lam Nguyen
• Eleanor Luzano Nguyen, PHN, RN
• Mary Nguyen, O.D.
• Pauline Anhmi Nguyen, PHARMD
• Phi Thai Nguyen, PHARMD
• Tran Nguyen, PHARMD
• Nicholas TJ Yatco DDS Inc

• Internal Medicine Physician in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.