Etc Consultants Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A69542 Issued in CA

Legal business name

ETC CONSULTANTS INC

Practice address

3151 Airway Ave Ste T3
Costa Mesa, CA 92626-4627

Phone

(949) 689-9754

Fax

(714) 545-5748

NPI assigned

Oct 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Charles Tuan-Tu Song Nguyen, M.D.NPI 1942380118

Title

Medical Director/Owner

Phone

(949) 689-9754

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lorphen Medical Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Tuan-Tu Song Nguyen, MD

  • Psychiatry Physician
  • Irvine, CA
  • NPI 1942380118
  NPD Authorized official
• Samantha Perkins

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Ana, CA
  • NPI 1790023281
  NPD
• Thu Phan, MSN, AGNP-C

  • Gerontology Nurse Practitioner
  • Downey, CA
  • NPI 1245779016
  NPD

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1891948717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 COLOMA",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926022438",
            "telephone_number": "949-689-9754",
            "fax_number": "949-313-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE T3",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264627",
            "telephone_number": "949-689-9754",
            "fax_number": "714-545-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETC CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "CHARLES TUAN-TU",
        "authorized_official_middle_name": "SONG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "949-689-9754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A69542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LECENSE",
            "identifier": "A69542",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lorphen Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jackeline Estrada
• Melisa Estrada
• Sara Estrada, LMFT
• Karen Estrella
• Raymond Estrella
• Suzan Janette Etheridge, AMFT
• Ethos Medical Supply, Inc.
• Randiann Ethridge, M.S.
• Kirsten Serena Gonzales Eustace, MS ATC
• Evagelos Coskinas MD a Medical Corporation

• Psychiatry Physician in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.