Individual provider Active NPI

Thuan Van Nguyen, M.D.

  • General Practice Physician
  • Gardena, CA
National Provider Identifier
1922143247
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A36037 Issued in CA
Practice address
15420 Crenshaw Blvd
Gardena, CA 90249-4524
Phone
(310) 324-5599
Fax
(310) 324-7550
NPI assigned
Feb 21, 2007
Last updated
Sep 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A36037 CA Primary

Addresses

Primary practice location

15420 Crenshaw Blvd
Gardena, CA 90249-4524

Mailing address

15420 Crenshaw Blvd
Gardena, CA 90249-4524
Phone (310) 324-5599

Other identifiers 1

IdentifierTypeStateIssuer
00A360370MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36037CAMDClinical Psychologist
A36037CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Le Healthcare PastSince Nov 29, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1922143247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15420 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494524",
            "telephone_number": "310-324-5599",
            "fax_number": "310-324-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494524",
            "telephone_number": "310-324-5599",
            "fax_number": "310-324-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THUAN",
        "middle_name": "VAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A36037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A360370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.