PHONG KY NGUYEN M.D NPI 1770699506

NPI Information

NPI: 1770699506
Provider Name: PHONG KY NGUYEN, M.D
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
350 TERRACINA BLVD
REDLANDS, CA
ZIP 92373
Phone: (909) 335-5500
Get Directions

Phong Ky Nguyen, M.D is a general practice in Redlands, CA with 37 years of experience. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Phong Ky Nguyen, M.D NPI is 1770699506. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduation Year:1987

The provider's business location address is:

350 TERRACINA BLVD
REDLANDS, CA
ZIP 92373-850
Phone: (909) 335-5500

The NPI 1770699506 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/22/2006 and was last updated on 9/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		A51595	CALIFORNIA	No
2	208D00000X	General Practice		A51595	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A515950	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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