Individual provider Active NPI

Tan The Nguyen, M.D.

  • Internal Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1609839299
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G67119 Issued in CA
Practice address
12865 Main St Ste 105
Garden Grove, CA 92840-8205
Phone
(800) 768-1977
Fax
(800) 768-1977
NPI assigned
Apr 6, 2006
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G67119 CA Primary

Addresses

Primary practice location

12865 Main St Ste 105
Garden Grove, CA 92840-8205

Mailing address

12865 Main St Ste 105
Garden Grove, CA 92840-8205
Phone (800) 760-5520

Other practice location 1

508 S Brookhurst St
Anaheim, CA 92804
Phone (800) 760-5520

Other practice location 2

508 S Brookhurst St
Anaheim, CA 92804
Phone (800) 760-5520

Other practice location 3

7514 Girard Ave
Suite 4
LA Jolla, CA 92037-5149
Phone (858) 754-1114

Other practice location 4

8700 Warner Ave Ste 270
Fountain Valley, CA 92708-3212
Phone (800) 560-9999

Other names 1

  • Dr. Tony Nguyen Professional name

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
I20081212000602 CA Practitioner - Internal Medicine 7810995362 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

508 S Brookhurst St
Anaheim, CA 92804-2416

8110 S Houghton Rd
Suite 158
Tucson, AZ 85747-4710

PO Box
Suite 15323
San Diego, CA 92175-5323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67119CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ted Medical Group, Inc. Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
House Call Medical Associates, Inc. CurrentSince Mar 29, 2017 Accepting new patients
NR Medical Associates Internal Medicine CurrentSince Jan 31, 2015 Accepting new patients
KND Development 59 LLC Current Accepting new patients
365 Medical Group, Inc Internal Medicine CurrentSince Jan 4, 2021 Accepting new patients
KND Development 59 LLC CurrentSince Sep 20, 2015 Accepting new patients
KND Development 59, LLC CurrentSince Sep 20, 2015 Accepting new patients

Locations

508 S Brookhurst St
Anaheim, CA 92804
Phone (800) 560-9999

17195 Newhope St
Ste 107
Fountain Valley, CA 92708
Phone (714) 444-2414

8700 Warner Ave
Ste 270
Fountain Valley, CA 92708
Phone (800) 560-9999

12865 Main St
Ste 105
Garden Grove, CA 92840
Phone (714) 360-0739

302 Washington St
San Diego, CA 92103
Phone (800) 790-0890

4940 El Cajon Blvd
San Diego, CA 92115
Phone (619) 543-4500

555 Washington St
San Diego, CA 92103
Phone (619) 260-8300

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wecare Hospice and PalliativeStanton, CA, CCN 921583 Hospice Contracted Managing Employee Oct 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1609839299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12865 MAIN ST STE 105",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928408205",
            "telephone_number": "800-760-5520",
            "fax_number": "800-760-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12865 MAIN ST STE 105",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928408205",
            "telephone_number": "800-768-1977",
            "fax_number": "800-768-1977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 S Brookhurst St",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "92804",
            "country_code": "US",
            "telephone_number": "800-760-5520",
            "fax_number": "800-760-5520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "508 S Brookhurst St",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "92804",
            "country_code": "US",
            "telephone_number": "800-760-5520",
            "fax_number": "800-760-5520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7514 Girard Ave",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920375149",
            "country_code": "US",
            "telephone_number": "858-754-1114",
            "fax_number": "858-228-9828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8700 Warner Ave Ste 270",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927083212",
            "country_code": "US",
            "telephone_number": "800-560-9999",
            "fax_number": "800-391-4191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAN",
        "middle_name": "THE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G67119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONY",
            "last_name": "NGUYEN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.