Individual provider Active NPI

Serena Young-Nguyen, M.D.

  • Orthopaedic Surgery Physician
  • Long Beach, CA
National Provider Identifier
1457351090
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G48372 Issued in CA
Practice address
701 E 28TH St Ste 117
Long Beach, CA 90806-2772
Phone
(562) 426-9890
Fax
(562) 426-7809
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G48372 CA Primary

Addresses

Primary practice location

701 E 28TH St Ste 117
Long Beach, CA 90806-2772

Mailing address

701 E 28TH St Ste 117
Long Beach, CA 90806-2772
Phone (562) 426-9890

Other identifiers 4

IdentifierTypeStateIssuer
G48372OtherCASTATE LECENSE
954721073OtherCATRICARE
G4837270OtherCABLUE CROSS/BLUE SHIELD
00G483720MedicaidCA

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
I20040405001305 CA Practitioner - Orthopedic Surgery 1456344605 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G48372CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William C. Kim, M.D., Inc Current Accepting new patients
William C. Kim, MD Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

701 E 28th St
Ste 117
Long Beach, CA 90806
Phone (562) 270-4849

4201 Torrance Blvd
Ste 190
Torrance, CA 90503
Phone (310) 543-2521

4320 Maricopa St
Torrance, CA 90503
Phone (310) 303-5900

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1457351090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST STE 117",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062772",
            "telephone_number": "562-426-9890",
            "fax_number": "562-426-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST STE 117",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062772",
            "telephone_number": "562-426-9890",
            "fax_number": "562-426-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG-NGUYEN",
        "first_name": "SERENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G48372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LECENSE",
            "identifier": "G48372",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "954721073",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "G4837270",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G483720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.