Individual provider Active NPI

Tracy Kim Nguyen

  • Gastroenterology Registered Nurse
  • Los Angeles, CA
National Provider Identifier
1780108373
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology Registered NurseTaxonomy code 163WG0100X
License
634182 Issued in CA
Practice address
1983 Marengo St
Los Angeles, CA 90033-1370
Phone
(323) 409-7974
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X 634182 CA Primary

Addresses

Primary practice location

1983 Marengo St
Los Angeles, CA 90033-1370

Mailing address

1983 Marengo St
Los Angeles, CA 90033-1370

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

LicenseStateTypeSpecialty
634182CAMDGastroenterology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1780108373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331370",
            "telephone_number": "323-409-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRACY",
        "middle_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "CA",
            "license": "634182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.