Individual provider Active NPI

Tam K Nguyen, M.D.

  • Internal Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1720153182
Registry record updated Apr 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A55848 Issued in CA
Practice address
12221 Brookhurst St Ste 100
Garden Grove, CA 92840-2848
Phone
(714) 805-8260
Fax
(714) 908-8086
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2023

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 A55848 CA Primary

Addresses

Primary practice location

12221 Brookhurst St Ste 100
Garden Grove, CA 92840-2848

Mailing address

19087 Chandon LN
Huntington Beach, CA 92648-2145
Phone (714) 757-3797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000989 CA Practitioner - Internal Medicine 6305917485 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19087 Chandon LN
Huntington Beach, CA 92648-2145

Hospital & facility affiliations

  • Master Home Health, Inc. Home health agency, Garden Grove, CA, CCN 757493
  • Delta Health Services Inc Home health agency, Fountain Valley, CA, CCN 757650
  • Abundant Grace Home Health Services, Inc Home health agency, San Dimas, CA, CCN 559470
  • Advantage Health Systems Home health agency, Costa Mesa, CA, CCN 059511
  • Excellence Home Health Care Agency Inc Home health agency, Chino, CA, CCN 058290
  • Rize Hospice Hospice, Anaheim, CA, CCN B51594

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55848CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Care Nursing, Inc CurrentSince Feb 17, 2015 Accepting new patients
Careconnectmd Ca PC CurrentSince Jun 16, 2024 Accepting new patients
GN Medical Associates, Inc. CurrentSince Jul 15, 2024 Accepting new patients

Locations

495 E Rincon St
Ste 105
Corona, CA 92879
Phone (888) 969-9808

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

17822 Beach Blvd
Ste 400
Huntington Beach, CA 92647
Phone (714) 332-7016

1750 Montgomery St
Fl 1
San Francisco, CA 94111
Phone (714) 619-8777

3401 W Sunflower Ave
#250
Santa Ana, CA 92704
Phone (415) 848-8258

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682121600000",
    "number": "1720153182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19087 CHANDON LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482145",
            "telephone_number": "714-757-3797",
            "fax_number": "714-541-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 BROOKHURST ST STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402848",
            "telephone_number": "714-805-8260",
            "fax_number": "714-908-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAM",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2023; 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.