Individual provider Active NPI

Ryan Quochu Nguyen, DO

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1831288406
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7395 Issued in CA
Practice address
3200 Long Beach Boulevard
Long Beach, CA 90806-5062
Phone
(562) 981-6865
Fax
(562) 595-6471
NPI assigned
Oct 12, 2006
Last updated
Nov 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7395 CA Primary

Addresses

Primary practice location

3200 Long Beach Boulevard
Long Beach, CA 90806-5062

Mailing address

2360 Pacific Ave
Long Beach, CA 90806-3051
Phone (562) 981-6856

Other identifiers 1

IdentifierTypeStateIssuer
00AX73950MedicaidCA

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
I20050726001247 CA Practitioner - Family Practice 0749224236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7395CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Jan 16, 2023 Accepting new patients
Central City Community Health Center Inc General Practice Past Accepting new patients
Universal Care Past Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ryan.nguyen.1@32527.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1831288406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908063051",
            "telephone_number": "562-981-6856",
            "fax_number": "562-981-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 LONG BEACH BOULEVARD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908065062",
            "telephone_number": "562-981-6865",
            "fax_number": "562-595-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "RYAN",
        "middle_name": "QUOCHU",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX73950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.