Thucdoan Thi Nguyen, P.A.
Individual provider Active NPI Physician Assistant · Bell, CA
NPI 1497827604 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497827604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA17458 (CA)
- Practice address
- 4129 Gage Ave
Bell, CA 90201-1128 - Phone
- (323) 771-8400
- Fax
- (323) 771-8750
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180219001024 | TX | Practitioner - Physician Assistant | 3274769336 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17458 | CA | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17458 | CA | Yes |
Addresses
Primary practice location
4129 Gage Ave
Bell, CA 90201-1128
Mailing address
1554 W Alexis Ave
Anaheim, CA 92802-1326
Phone (310) 619-9088
Other providers in Bell, CA
- Min Lee DDS
- Mojdeh Fatemi,DDS, a Professional Corporation
- Maia M Montoya
- Ruben Alejandro Munoz
- Alfonso Jose Najera
- Northeast Community Clinic
- Northeast Community Clinic
- Alexandra Isabel Novac
- Oscar Zambrano M.D. Inc
- Prisma Otanez
All providers in Bell, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.