Kimoanh Thi Nguyen

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95018074 Issued in CA

Practice address

12865 Main St Ste 105
Garden Grove, CA 92840-8205

Phone

(800) 768-1977

Fax

(800) 768-1977

NPI assigned

Dec 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• 365 Medical Group, Inc

  • Internal Medicine Physician
  • Garden Grove, CA
  • NPI 1780275016
  NPD

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1801556188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8052 CAMBRIA CIR",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906808503",
            "telephone_number": "714-270-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12865 MAIN ST STE 105",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928408205",
            "telephone_number": "800-768-1977",
            "fax_number": "800-768-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIMOANH",
        "middle_name": "THI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95018074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kieu-Nhi Nguyen, MT
• Kim Nguyen
• Kim-Tan Nguyen, M.D.
• Kimanh Nguyen, D.D.S.
• Kimchuyen Thi Nguyen
• Kristine Hoang Nguyen, PHARMD
• Lam Nguyen
• Lanhuong Thi Nguyen, M.D.
• Lawrence Thuy Nguyen
• Le Huyen Nguyen

• Nurse Practitioner in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.