Individual provider Active NPI

Minh Cao Nguyen, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1851731889
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125388 Issued in CA
Practice address
1100 N State St
Attn: Opd: Penny Pourat
Los Angeles, CA 90033-5000
Phone
(323) 226-5555
NPI assigned
Jul 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125388 CA Primary

Addresses

Primary practice location

1100 N State St
Attn: Opd: Penny Pourat
Los Angeles, CA 90033-5000

Mailing address

1200 N State St
Los Angeles, CA 90033-1029
Phone (323) 226-5555

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
I20140725000702 CA Practitioner - Psychiatry 2163648239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Geffen School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

2523 El Portal Dr
San Pablo, CA 94806-3305
Phone (510) 215-3730

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125388CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince Sep 26, 2023 Accepting new patients
Contra Costa County Current Accepting new patients
Contra Costa County CurrentSince Sep 26, 2023 Accepting new patients
Goldencast Medical Corporation PastSince May 1, 2008 Accepting new patients

Locations

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

13585 San Pablo Ave
Fl 2
San Pablo, CA 94806
Phone (510) 942-4700

Organizations & group practices 4

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": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1851731889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N STATE ST",
            "address_2": "ATTN: OPD: PENNY POURAT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335000",
            "telephone_number": "323-226-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MINH",
        "middle_name": "CAO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "125388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.