Organization Active NPI

Thang Phuoc Nguyen, MD, a Medical Corporation

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1477730166
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A66089 Issued in CA
Legal business name
THANG PHUOC NGUYEN, MD, A MEDICAL CORPORATION
Practice address
1271 S Union Ave
Los Angeles, CA 90015-2043
Phone
(213) 386-0214
Fax
(213) 386-0215
NPI assigned
Jan 25, 2008
Last updated
Jan 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Thang Phuoc Nguyen, M.D.NPI 1992729933
Title
Owner
Phone
(213) 386-0214

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
General Practice Physician 208D00000X A66089 CA Primary

Addresses

Primary practice location

1271 S Union Ave
Los Angeles, CA 90015-2043

Mailing address

1271 S Union Ave
Los Angeles, CA 90015-2043
Phone (213) 386-0214

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050830000417 CA Part B Supplier - Clinic/Group Practice 6901837905 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0980437Thang Nguyen MD Inc1271 S Union Ave, Los Angeles, CA 90015Certificate of waiverNov 20, 2026

National Provider Directory

National Provider Directory

Locations

1271 S Union Ave
Los Angeles, CA 90015
Phone (213) 386-0214

1271 S Union Ave
#C
Los Angeles, CA 90015
Phone (213) 386-0214

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1477730166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 S UNION AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152043",
            "telephone_number": "213-386-0214",
            "fax_number": "213-386-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 S UNION AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152043",
            "telephone_number": "213-386-0214",
            "fax_number": "213-386-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THANG PHUOC NGUYEN, MD, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THANG",
        "authorized_official_middle_name": "PHUOC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-386-0214",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A66089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.