Tam K Nguyen Medical Professional Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TAM K NGUYEN MEDICAL PROFESSIONAL CORP

Practice address

12221 Brookhurst St Ste 100
Garden Grove, CA 92840-2848

Phone

(714) 805-8260

Fax

(714) 908-8086

NPI assigned

Mar 23, 2012

Last updated

Apr 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tam K Nguyen, MDNPI 1720153182

Title

Ceo/President

Phone

(714) 757-3797

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• CT Clinic Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tam K Nguyen, M.D.

  • Internal Medicine Physician
  • Garden Grove, CA
  • NPI 1720153182
  Medicare reassignment Authorized official
• Richard David Le, M.D.

  • Pulmonary Disease Physician
  • Huntington Beach, CA
  • NPI 1528285012

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682121600000",
    "number": "1396011367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 BROOKHURST ST STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402848",
            "telephone_number": "714-805-8260",
            "fax_number": "714-908-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 BROOKHURST ST STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402848",
            "telephone_number": "714-805-8260",
            "fax_number": "714-908-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAM K NGUYEN MEDICAL PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "714-757-3797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A55848",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HA55858",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CT Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Felicia Tara Taing
• Todd Takasaki, RPH
• Khaldoun Takwa
• Abraham Talavera
• Desiree Nicole Talmadge
• Tam Nguyen Thi Pham MD Inc (Lighthouse Anesthesia Medical Group)
• Tam Pham DDS Inc (Mycare Dental)
• Tam Ton Dental, Inc
• Kyle Tam
• Yvonne Tam, DDS

• Internal Medicine Physician in Garden Grove, CA
• Providers in Garden Grove, 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 Apr 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.