Thach Bao Jonathan Nguyen, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A195490 Issued in CA

Practice address

9508 Stockdale Hwy Ste 150
Bakersfield, CA 93311-3623

Phone

(661) 663-7500

Fax

(661) 663-7503

NPI assigned

Apr 17, 2018

Last updated

Aug 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Kids, a Professional Medical Corporation

  dba Coastal Kids

  • Pediatrics Physician
  • Newport Beach, CA
  • NPI 1740311737
  NPD (past)
• Riverwalk Pediatric Clinic Inc

  • Pediatrics Physician
  • Bakersfield, CA
  • NPI 1417910886
  NPD (past)

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1912494873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9508 STOCKDALE HWY STE 150",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113623",
            "telephone_number": "661-663-7500",
            "fax_number": "661-663-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9508 STOCKDALE HWY STE 150",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113623",
            "telephone_number": "661-663-7500",
            "fax_number": "661-663-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THACH BAO JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A195490",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "30293",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.141244",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Dinh Khanh Nguyen, DO
• Scott Nguyen
• Sean Nguyen
• Son Nguyen, O.D.
• Tam Minh Nguyen, M.D.
• Tho Nguyen
• Thy Dung Khong Nguyen
• Tien Nguyen, M.D
• Tiffany T Nguyen
• Truong The Nguyen, DDS

• Pediatrics Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.