Organization Active NPI

Garden Grove Women's Health Specialists, Inc.

  • Obstetrics & Gynecology Physician
  • Garden Grove, CA
National Provider Identifier
1396960563
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A7161 Issued in CA
Legal business name
GARDEN GROVE WOMEN'S HEALTH SPECIALISTS, INC.
Practice address
12555 Garden Grove Blvd Ste 301
Garden Grove, CA 92843-1903
Phone
(714) 741-0501
Fax
(714) 741-0095
NPI assigned
Apr 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Authorized official

Name
Dr. Phu Nguyen, D.O.NPI 1386642866
Title
President
Phone
(714) 741-0501

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)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 20A7161 CA Primary

Addresses

Primary practice location

12555 Garden Grove Blvd Ste 301
Garden Grove, CA 92843-1903

Mailing address

12555 Garden Grove Blvd Ste 301
Garden Grove, CA 92843-1903
Phone (714) 741-0501

Other identifiers 1

IdentifierTypeStateIssuer
00AX71610MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040809000459 CA Part B Supplier - Clinic/Group Practice 7517939879 Receives reassigned benefits from 1 practitioner
Practice locations: Garden Grove, CA

National Provider Directory

National Provider Directory

Locations

12555 Garden Grove Blvd
Ste 301
Garden Grove, CA 92843
Phone (714) 741-0501

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

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": "1176508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1396960563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 GARDEN GROVE BLVD STE 301",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431903",
            "telephone_number": "714-741-0501",
            "fax_number": "714-741-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 GARDEN GROVE BLVD STE 301",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431903",
            "telephone_number": "714-741-0501",
            "fax_number": "714-741-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN GROVE WOMEN'S HEALTH SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-14",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-741-0501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A7161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX71610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.