Organization Active NPI

Trung Minh Nguyen, MD, Inc

  • Ophthalmic Technician/Technologist
  • Fountain Valley, CA
National Provider Identifier
1942471941
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
G079014 Issued in CA
Legal business name
TRUNG MINH NGUYEN, MD, INC
Practice address
11180 Warner Avenue
Suite 151
Fountain Valley, CA 92708
Phone
(714) 444-0303
Fax
(714) 444-2047
NPI assigned
Mar 18, 2008
Last updated
Mar 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Mr. Candyce Thu Minh Tran
Title
Office Manager
Phone
(714) 444-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X G079014 CA Primary

Addresses

Primary practice location

11180 Warner Avenue
Suite 151
Fountain Valley, CA 92708

Mailing address

11180 Warner Avenue
Suite 151
Fountain Valley, CA 92708
Phone (714) 444-0303

Other identifiers 1

IdentifierTypeStateIssuer
00G790140MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930100512 CA DME Supplier - Physician - OphthalmologyDME Supplier - Optician 3476766759 Practice locations: Fountain Valley, CA
O20110308000185 CA Part B Supplier - Clinic/Group Practice 3476766759 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Trung Minh Nguyen, MD, Inc11180 Warner Ave, Fountain Valley, CA 92708-7515(714) 444-0303 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Nov 6, 2001

National Provider Directory

National Provider Directory

Locations

11180 Warner Ave
Ste 151
Fountain Vly, CA 92708
Phone (714) 444-0303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1942471941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVENUE",
            "address_2": "SUITE 151",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-444-0303",
            "fax_number": "714-444-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVENUE",
            "address_2": "SUITE 151",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-444-0303",
            "fax_number": "714-444-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUNG MINH NGUYEN, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "CANDYCE",
        "authorized_official_middle_name": "THU MINH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-444-0303",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "CA",
            "license": "G079014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G790140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.