Active NPI
Chan Le Nguyen, M.D.
- Family Medicine Physician
- Westminster, CA
National Provider Identifier
1932390473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A100830
- Practice address
- 9353 Bolsa Ave # C-50
Westminster, CA 92683-5951 - Phone
- (714) 308-9466
- NPI assigned
- Aug 8, 2007
- Last updated
- Aug 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A100830 | CA | Primary |
Addresses
Primary practice location
9353 Bolsa Ave # C-50
Westminster, CA 92683-5951
Mailing address
9353 Bolsa Ave # C-50
Westminster, CA 92683-5951
Phone (714) 308-9466
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A100830 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bolsa Medical Group | Family Medicine | Current | Accepting new patients |
| Southland Integrated Services, Inc. | Past | Accepting new patients | |
| Bolsa Medical Group | Past | Accepting new patients |
Locations
10362 Bolsa Ave
Ste 110
Westminster, CA 92683
Phone (714) 531-2091
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GFCABD
Organizations & group practices 3
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.
-
- Non-Pharmacy Dispensing Site
- Westminster, CA
- NPI 1720423833
-
dba Integrated Community Services - Santa Ana
- Federally Qualified Health Center (FQHC)
- Santa Ana, CA
- NPI 1134636889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186531200000",
"number": "1932390473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9353 BOLSA AVE # C-50",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926835951",
"telephone_number": "714-308-9466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9353 BOLSA AVE # C-50",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926835951",
"telephone_number": "714-308-9466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "CHAN",
"middle_name": "LE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-08",
"last_updated": "2007-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A100830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Westminster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.