Individual provider Active NPI

Van Nguyen Greco, M.D.

  • Child Abuse Pediatrics Physician
  • Orange, CA
National Provider Identifier
1679895544
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X
License
A63824 Issued in CA
Practice address
101 The City Dr S
BLDG 56, Suite 600
Orange, CA 92868-3201
Phone
(714) 456-6933
Fax
(714) 456-7658
NPI assigned
Feb 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Abuse Pediatrics Physician 2080C0008X A63824 CA Primary

Addresses

Primary practice location

101 The City Dr S
BLDG 56, Suite 600
Orange, CA 92868-3201

Mailing address

101 The City Dr S
BLDG 56, Suite 600
Orange, CA 92868-3201
Phone (714) 456-6933

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
I20170207001683 CA Practitioner - Pediatric Medicine 2163705641 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A63824CAMDChild Abuse Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Uci Dept of Pediatrics CurrentSince Feb 1, 2017 Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 56
Orange, CA 92868
Phone (714) 456-5753

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1679895544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "address_2": "BLDG 56, SUITE 600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-6933",
            "fax_number": "714-456-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "address_2": "BLDG 56, SUITE 600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-6933",
            "fax_number": "714-456-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN GRECO",
        "first_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "CA",
            "license": "A63824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.