Individual provider Active NPI

Tam Thanh Huynh, M.D.

  • Internal Medicine Physician
  • Northridge, CA
National Provider Identifier
1487802674
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A105303 Issued in CA
Practice address
18638 Liggett St
Northridge, CA 91324-2922
Phone
(818) 554-7966
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A105303 CA Primary
Pediatrics Physician 208000000X A105303 CA

Addresses

Primary practice location

18638 Liggett St
Northridge, CA 91324-2922

Mailing address

18638 Liggett St
Northridge, CA 91324-2922
Phone (818) 554-7966

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
I20090211000386 CA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9032274840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinic Services of California Medical Group IncGroup PAC ID 7810209715, 65 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

Hospital & facility affiliations

  • Med Care Plus Home Health Inc Home health agency, Pasadena, CA, CCN 058155
  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105303CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Services of California Medical Group Inc CurrentSince Aug 1, 2018 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Oct 8, 2014 Accepting new patients

Locations

400 N Pepper Ave
Ste 301
Colton, CA 92324
Phone (909) 580-3366

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

1235 W Vine St
Ste 20
Lodi, CA 95240
Phone (209) 339-7600

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1487802674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18638 LIGGETT ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913242922",
            "telephone_number": "818-554-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18638 LIGGETT ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913242922",
            "telephone_number": "818-554-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "TAM",
        "middle_name": "THANH",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A105303",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A105303",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.