Individual provider Active NPI

Mandy Nguyen

  • Family Medicine Physician
  • Costa Mesa, CA
National Provider Identifier
1548849979
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A21480 Issued in CA
Practice address
1190 Baker St Ste 100
Costa Mesa, CA 92626-4105
Phone
(949) 791-3250
NPI assigned
Apr 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A21480 CA Primary

Addresses

Primary practice location

1190 Baker St Ste 100
Costa Mesa, CA 92626-4105

Mailing address

1190 Baker St Ste 100
Costa Mesa, CA 92626-4105

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
I20230801001603 CA Practitioner - Family Practice 6901267434 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Marian University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

1031 Avenida Pico
Suite 204
San Clemente, CA 92673-6352
Phone (949) 829-5533

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21480CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Aug 19, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Aug 5, 2023 Accepting new patients
Pih Health Physicians Family Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Aug 5, 2023 Accepting new patients
Pih Health Physicians CurrentSince Apr 28, 2024 Accepting new patients
Pih Health Physicians CurrentSince Apr 28, 2024 Accepting new patients
Applecare Hospitalist Medical Group, Inc. Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1190 Baker St
Ste 100
Costa Mesa, CA 92626
Phone (714) 668-2500

11500 Brookshire Ave
Ofc
Downey, CA 90241
Phone (562) 904-5000

1400 S Harbor Blvd
La Habra, CA 90631
Phone (714) 879-3400

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

601 Torrance Blvd
Redondo Beach, CA 90277
Phone (310) 316-0811

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1548849979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 BAKER ST STE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 BAKER ST STE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264105",
            "telephone_number": "949-791-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MANDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-04",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.