Individual provider Active NPI

Michael Tony Nguyen, DO

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1902392665
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18032 Issued in CA
Practice address
1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone
(213) 748-2411
NPI assigned
Jul 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2019038358 MO
Internal Medicine Physician 207R00000X 18032 CA Primary

Addresses

Primary practice location

1401 S Grand Ave
Los Angeles, CA 90015-3010

Mailing address

PO Box 1137
Livermore, CA 94551-1137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, 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
I20210722002188 MO Practitioner - Internal Medicine 8022411420 Reassigns benefits to 1 organization
I20220307001995 CA Practitioner - Internal Medicine 8022411420 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Group of Montebello IncGroup PAC ID 2264715143, 55 clinicians

Practice addresses (Care Compare)

1701 Santa Anita Ave
S El Monte, CA 91733-3411
Phone (626) 579-7777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019038358MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Ca PC CurrentSince Jun 23, 2022 Accepting new patients
Midwest Hospitalist Physicians LLP CurrentSince Jun 21, 2021 Accepting new patients
Hospitalist Group of Montebello Inc CurrentSince Aug 1, 2022 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients
Im-FSR Inc. CurrentSince Jun 1, 2025 Accepting new patients
Clinic Services of California Medical Group Inc CurrentSince Mar 1, 2022 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

2701 S Bristol St
Santa Ana, CA 92704
Phone (714) 636-0342

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

315 S Osteopathy Ave
Kirksville, MO 63501
Phone (660) 785-1000

1515 Union Ave
Moberly, MO 65270
Phone (660) 263-2400

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": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1902392665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945511137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153010",
            "telephone_number": "213-748-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MICHAEL",
        "middle_name": "TONY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2019038358",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "18032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.