Individual provider Active NPI

Phuong Thanh Nguyen, MEDICAL PROVIDER

  • General Acute Care Hospital
  • Garden Grove, CA
National Provider Identifier
1992191480
Registry record updated Apr 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Practice address
11712 Banner Dr
Garden Grove, CA 92843-2707
Phone
(714) 785-4111
NPI assigned
Apr 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

11712 Banner Dr
Garden Grove, CA 92843-2707

Mailing address

11712 Banner Dr
Garden Grove, CA 92843-2707
Phone (714) 785-4111

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

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1992191480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 BANNER DR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432707",
            "telephone_number": "714-785-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11712 BANNER DR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432707",
            "telephone_number": "714-785-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "middle_name": "THANH",
        "credential": "MEDICAL PROVIDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.