Individual provider Active NPI

Paul Nguyenfa, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1831535749
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A136278 Issued in CA
Practice address
757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone
(310) 825-9111
NPI assigned
May 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A136278 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

757 Westwood PLZ
Los Angeles, CA 90095-8358

Mailing address

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 825-9111

Other practice location 1

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 447-5027

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
I20160823002459 CA Practitioner - Internal Medicine 5496040917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1514 Valley Vista Dr
Diamond Bar, CA 91765-3929
Phone (909) 860-1144

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136278CAMDMarriage & Family Therapist
A136278CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Single Specialty Current Accepting new patients
Providence Medical Foundation CurrentSince Aug 15, 2016 Accepting new patients
Providence Medical Foundation Single Specialty CurrentSince Aug 15, 2016 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

100 E Valencia Mesa Dr
Ste 311
Fullerton, CA 92835
Phone (714) 446-5180

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1368835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1831535749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-825-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-825-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Valencia Mesa Dr",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353809",
            "country_code": "US",
            "telephone_number": "714-447-5027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYENFA",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A136278",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.