Individual provider Active NPI

Hong Phuc Nguyen, DO

  • Internal Medicine Physician
  • Lancaster, CA
National Provider Identifier
1992995997
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A11360 Issued in CA
Practice address
44469 10TH St W
Lancaster, CA 93534-3324
Phone
(661) 945-9411
Fax
(661) 945-2035
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N6536 TX
Internal Medicine Physician 207R00000X 5101017225 MI
Internal Medicine Physician 207R00000X 20A11360 CA Primary

Addresses

Primary practice location

44469 10TH St W
Lancaster, CA 93534-3324

Mailing address

44469 10TH St W
Lancaster, CA 93534-3324
Phone (661) 945-9411

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120601000303 CA Practitioner - Internal Medicine 7810176724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Medical Group Holding Company, Inc.Group PAC ID 9335185594, 9 clinicians

Practice addresses (Care Compare)

44469 10TH St W
Lancaster, CA 93534-3324
Phone (661) 945-9411

Hospital & facility affiliations

  • Beta Hospice Care Inc Hospice, San Bernardino, CA, CCN A11527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20A11360CAMDInternal Medicine Physician
5101017225MIMDInternal Medicine Physician

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
Sierra Medical Group Holding Company, Inc. Internal Medicine CurrentSince Apr 7, 2012 Accepting new patients

Locations

44469 10th St W
Lancaster, CA 93534
Phone (661) 945-9411

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1992995997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44469 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343324",
            "telephone_number": "661-945-9411",
            "fax_number": "661-945-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44469 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343324",
            "telephone_number": "661-945-9411",
            "fax_number": "661-945-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HONG PHUC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N6536",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101017225",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A11360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.