Individual provider Active NPI

Chan Le Nguyen, M.D.

  • Family Medicine Physician
  • Westminster, CA
National Provider Identifier
1932390473
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A100830 Issued in CA
Practice address
9353 Bolsa Ave # C-50
Westminster, CA 92683-5951
Phone
(714) 308-9466
NPI assigned
Aug 8, 2007
Last updated
Aug 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071130000607 CA Practitioner - Family PracticePractitioner - General Practice 9032208814 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100830CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bolsa Medical Group Family Medicine CurrentSince Dec 8, 2024 Accepting new patients
Southland Integrated Services, Inc. Past Accepting new patients
Bolsa Medical Group PastSince Dec 8, 2024 Accepting new patients

Locations

10362 Bolsa Ave
Ste 110
Westminster, CA 92683
Phone (714) 531-2091

Interoperability endpoints

  • FHIR API: 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.

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

Verify at the official NPI Registry.