NPIMap

Organization Active NPI

Hoi-Quan Cuu Long Mekong Community Center Inc

Doing business as Mekong Community Center

  • Community/Behavioral Health Agency
  • San Jose, CA
National Provider Identifier
1548318199
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
01047100 Issued in CA
Legal business name
HOI-QUAN CUU LONG MEKONG COMMUNITY CENTER INC
Doing business as
Mekong Community Center
Practice address
2670 S White Rd Ste 200
San Jose, CA 95148-2073
Phone
(408) 937-1553
Fax
(408) 937-1548
NPI assigned
Jan 8, 2007
Last updated
Jul 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Authorized official

Name
Mr. Long Thien Vu, LCSWNPI 1811267016
Title
Ceo
Phone
(408) 914-2880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 01047100 CA Primary

Addresses

Primary practice location

2670 S White Rd Ste 200
San Jose, CA 95148-2073

Mailing address

2670 S White Rd Ste 200
San Jose, CA 95148-2073
Phone (408) 937-1553

Other names 1

  • Mekong Community Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050921001160 CA Part B Supplier - Clinic/Group Practice 1658305313 Receives reassigned benefits from 2 practitioners
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory
Tax ID family
Hoi Quan Cuu Long- Mekong Community Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1661 Burdette Dr
Ste C
San Jose, CA 95121
Phone (408) 274-2453

2670 S White Rd
Ste 200
San Jose, CA 95148
Phone (408) 914-2880

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1548318199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 S WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482073",
            "telephone_number": "408-937-1553",
            "fax_number": "408-937-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 S WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482073",
            "telephone_number": "408-937-1553",
            "fax_number": "408-937-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOI-QUAN CUU LONG MEKONG COMMUNITY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "LONG",
        "authorized_official_middle_name": "THIEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-914-2880",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "01047100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mekong Community Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.