Active NPI
Michelle Minh-Tam Nguyen
- Pediatrics Physician
- Loma Linda, CA
National Provider Identifier
1962149468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- PTL4093
- Practice address
- 11234 Anderson St
Loma Linda, CA 92350-1716 - Phone
- (408) 355-8200
- NPI assigned
- May 16, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | PTL4093 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Loma Linda, CA 92350-1716
Mailing address
10586 Mountain View Ave
Apt H
Redlands, CA 92373-5204
Phone (408) 355-8200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL4093 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736467200000",
"number": "1962149468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10586 MOUNTAIN VIEW AVE",
"address_2": "APT H",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735204",
"telephone_number": "408-355-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501716",
"telephone_number": "408-355-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MICHELLE",
"middle_name": "MINH-TAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-16",
"last_updated": "2025-01-10",
"certification_date": "2025-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "PTL4093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.