Active NPI
Kevin Anh Vu Le Nguyen
- Pharmacist
- Aliso Viejo, CA
National Provider Identifier
1619568391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 83968
- Practice address
- 200 Freedom LN
Aliso Viejo, CA 92656-5876 - Phone
- (949) 900-8437
- NPI assigned
- Jan 26, 2021
- Last updated
- Mar 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 83968 | CA | Primary |
Addresses
Primary practice location
200 Freedom LN
Aliso Viejo, CA 92656-5876
Mailing address
1163 E Little Dr
Placentia, CA 92870-5268
Phone (714) 616-6954
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83968 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 2
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": "1611619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1619568391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1163 E LITTLE DR",
"city": "PLACENTIA",
"state": "CA",
"postal_code": "928705268",
"telephone_number": "714-616-6954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 FREEDOM LN",
"city": "ALISO VIEJO",
"state": "CA",
"postal_code": "926565876",
"telephone_number": "949-900-8437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KEVIN",
"middle_name": "ANH VU LE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-26",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "83968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aliso Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.