Nhan Hoa Comprenesive Health Care Clinic Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Garden Grove, CA

NPI 1497889158 · NPPES record last updated May 12, 2020

Key facts

NPI
1497889158
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
060000324 (CA)
Legal business name
NHAN HOA COMPRENESIVE HEALTH CARE CLINIC INC.
Practice address
7761 Garden Grove Blvd.
Garden Grove, CA 92841-4200
Phone
(714) 898-8888
Fax
(714) 901-7580
NPI assigned
Mar 15, 2007
Organization subpart
No

Authorized official

Name
Jenny Quynh Nguyen
Title
Chief Executive Officer
Phone
(714) 898-8888

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

Federally qualified health center certification: CCN 751065

Legal name
NHAN HOA COMPREHENSIVE HEALTH CARE CLINIC INC.
Doing business as
NHAN HOA COMPREHENSIVE HEALTH CARE CLINIC, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 22, 2014
Last certification
Apr 22, 2014
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Sep 19, 1992 in CA
Enrollment address
7761 Garden Grove Blvd
Garden Grove, CA 92841-4200

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jenny Nguyen
Individual
Corporate Officer
Chief Executive Officer
Oct 15, 2018 100%
Operational/Managerial Control
Chief Executive Officer
Oct 15, 2018 100%
Duc Hong Vuong
Individual
Corporate Director
Treasurer
Jan 1, 1993 24%
Khang Bao
Individual
Corporate Director
Board of Director Member
Sep 24, 2020 1%
Stacey OT Le
Individual
Corporate Director
Secretary
Nov 26, 2020 24%
Thanh Tam Tran
Individual
W-2 Managing Employee
Human Resources Manager
Sep 12, 2016 1%
Kim Phuong Nguyen
Individual
Corporate Director
Board Member
Oct 29, 2020 1%
Dung H Nguyen
Individual
W-2 Managing Employee
Office Manager
Jun 1, 2005 1%
Tuan Xuan Nguyen
Individual
Corporate Director
Vice Chairman
Nov 29, 2019 24%
Nam X Nguyen
Individual
Corporate Director
Chairman
Nov 26, 2020 24%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110531000061 CA Part B Supplier - Clinic/Group Practice 0446273882 Receives reassigned benefits from 16 practitioners
Practice locations: Garden Grove, CA
O20140421001161 CA Part a Provider - Federally Qualified Health Center (FQHC) 0446273882 Practice locations: Garden Grove, CA

National Provider Directory

Medicare enrollment (NPD)
No

Locations

7761 Garden Grove Blvd
Garden Grove, CA 92841
Phone (714) 898-8888

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 060000324 CA
Federally Qualified Health Center (FQHC) 261QF0400X 060000324 CA Yes
Health Maintenance Organization 302R00000X 060000324 CA

Addresses

Primary practice location

7761 Garden Grove Blvd.
Garden Grove, CA 92841-4200

Mailing address

7761 Garden Grove Blvd.
Garden Grove, CA 92841-4200
Phone (714) 898-8888

Other names

  • Nhan Hoa Comprehensive Health Care Clinic Inc. Doing business as

Other providers in Garden Grove, CA

All providers in Garden Grove, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.