Individual provider Active NPI

Mitchell Nguyen

  • Physical Therapist
  • Redondo Beach, CA
National Provider Identifier
1588517874
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305075 Issued in CA
Practice address
801 S Pacific Coast Hwy
Redondo Beach, CA 90277-4764
Phone
(424) 349-5206
NPI assigned
Feb 17, 2026
Last updated
Feb 17, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 305075 CA Primary

Addresses

Primary practice location

801 S Pacific Coast Hwy
Redondo Beach, CA 90277-4764

Mailing address

4510 W 137TH PL
Hawthorne, CA 90250-6908

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260313003659 CA Practitioner - Physical Therapist in Private Practice 4082197330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Life Physical Therapy Services PCGroup PAC ID 7214207125, 94 clinicians

Practice addresses (Care Compare)

801 S Pacific Coast Hwy
Redondo Beach, CA 90277-4764
Phone (424) 317-6869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305075CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Physical Therapy Services, PC Physical Therapist CurrentSince Feb 2, 2026 Accepting new patients

Locations

801 S Pacific Coast Hwy
Redondo Beach, CA 90277
Phone (424) 317-6869

Organizations & group practices 1

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": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1588517874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 W 137TH PL",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PACIFIC COAST HWY",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902774764",
            "telephone_number": "424-349-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MITCHELL",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.