Individual provider Active NPI

Thanh Van Nguyen, M.D.

  • Otolaryngology Physician
  • Fountain Valley, CA
National Provider Identifier
1508862061
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G85166 Issued in CA
Practice address
10760 Warner Avenue
201
Fountain Valley, CA 92708-3845
Phone
(714) 593-5356
Fax
(714) 593-5366
NPI assigned
Jun 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G85166 CA Primary

Addresses

Primary practice location

10760 Warner Avenue
201
Fountain Valley, CA 92708-3845

Mailing address

10760 Warner Avenue
201
Fountain Valley, CA 92708-3845
Phone (714) 593-5356

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
I20080228000233 CA Practitioner - Otolaryngology 8022054964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, San Francisco School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10760 Warner Ave
Suite 201
Fountain Valley, CA 92708-3857
Phone (714) 593-5356

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85166CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thanh-Van Ngoc Nguyen MD a Professional Medical Corporation Otolaryngology CurrentSince Mar 3, 2003 Accepting new patients
Memorialcare Medical Foundation CurrentSince Apr 1, 2011 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

10760 Warner Ave
Ste 201
Fountain Vly, CA 92708
Phone (714) 593-5356

18561 Beach Blvd
Huntington Beach, CA 92648
Phone (714) 848-0080

9122 Adams Ave
Huntington Beach, CA 92646
Phone (714) 378-0900

15464 Goldenwest St
Westminster, CA 92683
Phone (714) 891-9008

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508862061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10760 WARNER AVENUE",
            "address_2": "201",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083845",
            "telephone_number": "714-593-5356",
            "fax_number": "714-593-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10760 WARNER AVENUE",
            "address_2": "201",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083845",
            "telephone_number": "714-593-5356",
            "fax_number": "714-593-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THANH",
        "middle_name": "VAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G85166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.