Individual provider Active NPI

Son Truong Nguyen, M.D.

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1811285422
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A129440 Issued in CA
Practice address
3610 Atlantic Ave
Long Beach, CA 90807-3418
Phone
(562) 424-8814
Fax
(562) 427-2604
NPI assigned
Jul 17, 2011
Last updated
Aug 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Internal Medicine Physician 207R00000X A129440 CA Primary

Addresses

Primary practice location

3610 Atlantic Ave
Long Beach, CA 90807-3418

Mailing address

PO Box 17369
Long Beach, CA 90807-7369
Phone (562) 424-8814

Other names 1

  • Sonny 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
I20141210000025 CA Practitioner - Internal Medicine 5698097244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Healthcare Medical Associates IncGroup PAC ID 5294647574, 109 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129440CAMDMarriage & Family Therapist
A129440CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Oct 8, 2014 Accepting new patients
Clinic Services of California Medical Group Inc CurrentSince Aug 1, 2018 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

8851 Center Dr
Ste 600
La Mesa, CA 91942
Phone (619) 589-0785

1235 W Vine St
Ste 20
Lodi, CA 95240
Phone (209) 339-7410

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

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": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1811285422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17369",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908077369",
            "telephone_number": "562-424-8814",
            "fax_number": "562-427-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073418",
            "telephone_number": "562-424-8814",
            "fax_number": "562-427-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "SON",
        "middle_name": "TRUONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-17",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A129440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONNY",
            "last_name": "NGUYEN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.