Individual provider Active NPI

John Nguyen, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1770724544
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A106896 Issued in CA
Practice address
1200 N State St # 14901
Los Angeles, CA 90033-1029
Phone
(818) 473-0006
Fax
(714) 740-5032
NPI assigned
Mar 9, 2009
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A106896 CA
Anesthesiology Physician 207L00000X A106896 CA Primary

Addresses

Primary practice location

1200 N State St # 14901
Los Angeles, CA 90033-1029

Mailing address

1401 N Huron Dr
Santa Ana, CA 92706-3133

Other names 1

  • Johnkim Nguyen Other 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
I20110728000069 CA Practitioner - Anesthesiology 7810165388 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Associates PCGroup PAC ID 4385070549, 24 clinicians
South Bay Anesthesia Medical Group IncGroup PAC ID 6406899707, 31 clinicians

Practice addresses (Care Compare)

1300 W 7TH St
San Pedro, CA 90732-3505
Phone (310) 832-3311

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 540-7676

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A106896CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Anesthesia Medical Group Inc. Anesthesiology CurrentSince Jul 1, 2011 Accepting new patients
Professional Anesthesia Associates PC Anesthesiology CurrentSince Sep 8, 2021 Accepting new patients

Locations

514 N Prospect Ave
Ste 100
Redondo Beach, CA 90277
Phone (310) 376-2007

1300 W 7th St
San Pedro, CA 90732
Phone (310) 514-5350

23500 Madison St
Torrance, CA 90505
Phone (310) 539-5120

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Riverside Heights Healthcare Center LLCRiverside, CA, CCN 555884 Skilled nursing facility 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Apr 1, 2015
Apr 1, 2015
Griffith Park Healthcare CenterGlendale, CA, CCN 056111 Skilled nursing facility 5% Or Greater Direct Ownership Interest (10%)
Corporate Director (10%)
Jun 30, 2015
Jun 30, 2015
Santa Fe Heights Healthcare Center LLCCompton, CA, CCN 555732 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (20%) Aug 15, 2024

Owned or controlled facilities with NPI records 3

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

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.

Hospital & facility affiliations 1

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": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1770724544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N HURON DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST # 14901",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "818-473-0006",
            "fax_number": "714-740-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-09",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A106896",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A106896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNKIM",
            "last_name": "NGUYEN",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.