Individual provider Active NPI

David Thanh Nguyen, D.O.

  • Neurology Physician
  • San Diego, CA
National Provider Identifier
1891050712
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
20A14415 Issued in CA
Practice address
4405 Vandever Ave
San Diego, CA 92120-3315
Phone
(619) 516-6890
NPI assigned
Jul 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 20A14415 CA Primary

Addresses

Primary practice location

4405 Vandever Ave
San Diego, CA 92120-3315

Mailing address

4405 Vandever Ave
San Diego, CA 92120-3315
Phone (619) 532-6222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171017001928 HI Practitioner - Neurology 1153620190 Reassigns benefits to 2 organizations
I20210511002768 CA Practitioner - Neurology 1153620190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

9455 Clairemont Mesa Blvd
San Diego, CA 92123-1297
Phone (858) 573-1504

Hospital & facility affiliations

  • Kaiser Foundation Hospital - San Diego Hospital, San Diego, CA, CCN 050515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14415CAMDAcupuncturist
20A14415CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 12, 2021 Accepting new patients
Pali Momi Medical Center CurrentSince Sep 25, 2017 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 12, 2021 Accepting new patients
Pali Momi Medical Center CurrentSince Sep 25, 2017 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

4405 Vandever Ave
San Diego, CA 92120
Phone (619) 516-6223

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

98-1079 Moanalua Rd
Ste 680
Aiea, HI 96701
Phone (808) 485-4250

Organizations & group practices 6

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1891050712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 VANDEVER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203315",
            "telephone_number": "619-532-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 VANDEVER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203315",
            "telephone_number": "619-516-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DAVID",
        "middle_name": "THANH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A14415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.