Individual provider Active NPI

Vivian Thao Nguyen, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1487926788
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
38218 Issued in CA
Practice address
11500 W Olympic Blvd
Suite 350
Los Angeles, CA 90064-1524
Phone
(310) 473-8287
NPI assigned
Feb 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 38218 CA Primary

Addresses

Primary practice location

11500 W Olympic Blvd
Suite 350
Los Angeles, CA 90064-1524

Mailing address

761 S Morningstar Dr
Anaheim, CA 92808-1633
Phone (714) 264-9733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130110000194 CA Practitioner - Physical Therapist in Private Practice 5395998900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Senior Living LLCGroup PAC ID 0446754451, 117 clinicians

Practice addresses (Care Compare)

5308 Monroe Ave
San Diego, CA 92115-3427
Phone (619) 314-6382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38218CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Senior Living LLC Physical Therapist CurrentSince Feb 16, 2026 Accepting new patients
Reliant Senior Living LLC Physical Therapist CurrentSince Feb 16, 2026 Accepting new patients
Momentum Physical Therapy Physical Therapist CurrentSince Jan 12, 2012 Accepting new patients
Prendergast and Rummer Phys Therapy Pelvic Health & Rehabiliation Ctr Physical Therapist PastSince Dec 1, 2024 Accepting new patients

Locations

11500 W Olympic Blvd
Ste 470
Los Angeles, CA 90064
Phone (310) 473-8287

11500 W Olympic Blvd
Ste 350
Los Angeles, CA 90064
Phone (310) 473-8287

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1487926788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 S MORNINGSTAR DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081633",
            "telephone_number": "714-264-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD",
            "address_2": "SUITE 350",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641524",
            "telephone_number": "310-473-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VIVIAN",
        "middle_name": "THAO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38218",
            "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 Feb 1, 2012; 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.