Kychuong Van, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A34430 Issued in CA

Practice address

10362 Bolsa Ave
Bolsa Medical Group
Westminster, CA 92683-6763

Phone

(714) 531-2091

Fax

(714) 531-1403

NPI assigned

Jun 26, 2006

Last updated

Dec 12, 2011By 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 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kychuong.van@bolsamg.directbygreenway.com

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.

• Bolsa Medical Group

  • Surgery Physician
  • Westminster, CA
  • NPI 1992732192
  Medicare reassignment NPD
• Bolsa Medical Group

  • Non-Pharmacy Dispensing Site
  • Westminster, CA
  • NPI 1720423833
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1942237144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10362 BOLSA AVE",
            "address_2": "BOLSA MEDICAL GROUP",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836763",
            "telephone_number": "714-531-2091",
            "fax_number": "714-531-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10362 BOLSA AVE",
            "address_2": "BOLSA MEDICAL GROUP",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836763",
            "telephone_number": "714-531-2091",
            "fax_number": "714-531-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "KYCHUONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A34430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A344300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Usv Optical Inc
• Ariel Elizabeth Valdez, SLPA
• William Roy Valdivia I, LICENSED PSYCHIATRIC
• Van the Nguyen, M.D.
• Cheri Van
• Tammy Van
• Thu Hoa Victoria Van, M.D.
• Vanthi Pham, DDS, Inc
• Venus Health Inc
• Mireya Vera

• Surgery Physician in Westminster, CA
• Providers in Westminster, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.