Individual provider Active NPI

Daniel Tran-Hoa Nguyen, PA-C

  • Medical Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1962047365
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA57491 Issued in CA
Practice address
11190 Warner Ave Ste 300
Fountain Valley, CA 92708-4045
Phone
(714) 241-7000
Fax
(714) 241-7003
NPI assigned
Nov 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA57491 CA
Medical Physician Assistant 363AM0700X PA57491 CA Primary

Addresses

Primary practice location

11190 Warner Ave Ste 300
Fountain Valley, CA 92708-4045

Mailing address

11190 Warner Ave Ste 300
Fountain Valley, CA 92708-4045
Phone (714) 241-7000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200401001571 CA Practitioner - Physician Assistant 4688003312 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57491CAMDMarriage & Family Therapist
PA57491CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthowest Physician Assistant CurrentSince Dec 1, 2020 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Jan 23, 2023 Accepting new patients
Orthowest CurrentSince Dec 1, 2020 Accepting new patients
Express Care Wa PC PastSince Apr 19, 2020 Accepting new patients

Locations

11190 Warner Ave
Ste 300
Fountain Vly, CA 92708
Phone (714) 241-7000

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

22 Odyssey
Ste 205
Irvine, CA 92618
Phone (949) 870-3332

24331 El Toro Rd
Ste 200
Laguna Woods, CA 92637
Phone (949) 767-0800

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1962047365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11190 WARNER AVE STE 300",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084045",
            "telephone_number": "714-241-7000",
            "fax_number": "714-241-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 WARNER AVE STE 300",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084045",
            "telephone_number": "714-241-7000",
            "fax_number": "714-241-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DANIEL",
        "middle_name": "TRAN-HOA",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-10",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57491",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA57491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.