Individual provider Active NPI

Jane Ngoc Nguyen, PA-C

  • Physician Assistant
  • Anaheim, CA
National Provider Identifier
1821455767
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53171 Issued in CA
Practice address
631 S Brookhurst St
Suite 101
Anaheim, CA 92804-3510
Phone
(714) 991-5700
NPI assigned
Jan 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53171 CA Primary

Addresses

Primary practice location

631 S Brookhurst St
Suite 101
Anaheim, CA 92804-3510

Mailing address

2222 W Manly Ave
Santa Ana, CA 92704-6029
Phone (714) 414-9984

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200226000627 CA Practitioner - Physician Assistant 1052748316 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Nahla Salem M D IncGroup PAC ID 2860540762, 5 clinicians

Practice addresses (Care Compare)

17672 Beach Blvd
Suite Ab
Huntington Beach, CA 92647-6836
Phone (714) 698-8762

2001 E 4TH St
Suite 104
Santa Ana, CA 92705-3916
Phone (657) 230-7800

23653 El Toro Rd
Suite B
Lake Forest, CA 92630-8614
Phone (949) 317-0312

4720 E Chapman Ave
Orange, CA 92869-4113
Phone (714) 771-7600

610 E Katella Ave
Orange, CA 92867-4954
Phone (714) 694-2001

631 S Brookhurst St
Suite 101
Anaheim, CA 92804-3563
Phone (714) 991-5700

8101 Newman Ave
Suite a
Huntington Beach, CA 92647-7042
Phone (714) 698-8580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Urgentcare Medical Group Incorporated CurrentSince Jan 7, 2020 Accepting new patients

Locations

631 S Brookhurst St
Ste 101
Anaheim, CA 92804
Phone (714) 991-5700

8101 Newman Ave
Ste B
Huntington Beach, CA 92647
Phone (714) 847-3030

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1821455767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W MANLY AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046029",
            "telephone_number": "714-414-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S BROOKHURST ST",
            "address_2": "SUITE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043510",
            "telephone_number": "714-991-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JANE",
        "middle_name": "NGOC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.