Individual provider Active NPI

Quan Minh Kenny Nguyen

  • Physician Assistant
  • Laguna Niguel, CA
National Provider Identifier
1912619214
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
30281 Golden Lantern
Laguna Niguel, CA 92677-5979
Phone
(949) 495-7144
NPI assigned
Dec 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

30281 Golden Lantern
Laguna Niguel, CA 92677-5979

Mailing address

30281 Golden Lantern
Laguna Niguel, CA 92677-5979

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230310002530 CA Practitioner - Physician Assistant 1658744735 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
62260CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cassidy Medical Group Inc. Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 23, 2024 Accepting new patients
Beaver Medical Group P C Current Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

30281 Golden Lantern
Laguna Niguel, CA 92677
Phone (858) 788-4040

4910 Airport Plaza Dr
Ste 210
Long Beach, CA 90815
Phone (562) 421-3727

3460 Katella Ave
Los Alamitos, CA 90720
Phone (310) 594-6599

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

Interoperability endpoints

  • Direct secure messaging: quan.nguyen.p15@direct.monarchhealthcare.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1912619214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30281 GOLDEN LANTERN",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30281 GOLDEN LANTERN",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775979",
            "telephone_number": "949-495-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "QUAN",
        "middle_name": "MINH KENNY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.