Kevin Dathien Nguyen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

58123 Issued in CA

Practice address

1501 E Holt Ave # a
Pomona, CA 91767-5823

Phone

(909) 623-3600

NPI assigned

Jun 5, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unicare Community Health Center, Inc.Group PAC ID 8426369067, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1639066491
  Medicare reassignment Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1205393238
  NPD
• Unicare Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Huntington Park, CA
  • NPI 1871484618
  NPD

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1902420912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E HOLT AVE",
            "address_2": "STE A",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675823",
            "telephone_number": "909-988-2555",
            "fax_number": "909-460-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E HOLT AVE # A",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675823",
            "telephone_number": "909-623-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KEVIN",
        "middle_name": "DATHIEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Nguyen, PT
• Joseph Nguyen
• Justin Diep Nguyen
• Kendrick Nguyen
• Kenny Nguyen
• Kevin Thuc-Toan Nguyen
• Kim Thien Nguyen
• Lannhi Nguyen
• Laura Tran Dinh Bao Nguyen
• Linda Nguyen, O.D.

• Physician Assistant in Pomona, CA
• Providers in Pomona, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.