Individual provider Active NPI

Dau Van Nguyen, M.D.

  • Psychiatry Physician
  • San Bernardino, CA
National Provider Identifier
1578515375
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A67773 Issued in CA
Practice address
303 E Vanderbilt Way
San Bernardino, CA 92415-0026
Phone
(909) 252-5149
NPI assigned
May 17, 2006
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A67773 CA Primary

Addresses

Primary practice location

303 E Vanderbilt Way
San Bernardino, CA 92415-0026

Mailing address

303 E Vanderbilt Way
San Bernardino, CA 92415-0026
Phone (909) 252-5149

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
I20040527000662 CA Practitioner - Psychiatry 9436130259 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67773CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Jul 3, 2000 Accepting new patients
Department of State Hospitals Current Accepting new patients
County of San Bernardino Current Accepting new patients
Department of State Hospitals CurrentSince Jul 3, 2000 Accepting new patients
County of San Bernardino CurrentSince Dec 13, 2014 Accepting new patients
County of San Bernardino CurrentSince Dec 13, 2014 Accepting new patients

Locations

17053 Foothill Blvd
Bldg B
Fontana, CA 92335
Phone (909) 347-1300

2940 Inland Empire Blvd
Ontario, CA 91764
Phone (909) 458-1350

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

3102 E Highland Ave
Ofc
Patton, CA 92369
Phone (909) 425-7000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1578515375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-252-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-252-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DAU",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A67773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.