Individual provider Active NPI

Trang Nguyen, D.O.

  • Internal Medicine Physician
  • Wildomar, CA
National Provider Identifier
1861836207
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A15645 Issued in CA
Practice address
36485 Inland Valley Dr
Wildomar, CA 92595-9681
Phone
(951) 304-7187
NPI assigned
Apr 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A15645 CA Primary

Addresses

Primary practice location

36485 Inland Valley Dr
Wildomar, CA 92595-9681

Mailing address

601 E Harvard St
Glendale, CA 91205-1166

Other practice location 1

1575 Washington Street
Watertown, NY 13601
Phone (315) 786-7300

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
I20170925003620 CA Practitioner - Internal Medicine 2062630239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Associates of California PCGroup PAC ID 2668812215, 55 clinicians

Practice addresses (Care Compare)

36485 Inland Valley Dr
Wildomar, CA 92595-9681
Phone (951) 677-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15645CAMDInternal Medicine Physician
15645CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Associates of California PC Internal Medicine CurrentSince Feb 18, 2024 Accepting new patients

Locations

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

Organizations & group practices 1

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 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": "1367020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1861836207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E HARVARD ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36485 INLAND VALLEY DR",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959681",
            "telephone_number": "951-304-7187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 Washington Street",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "13601",
            "country_code": "US",
            "telephone_number": "315-786-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRANG",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A15645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.