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

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NPI Details

Phong Ky Nguyen, M.D is a general practice in Redlands, CA with 39 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
1207P00000XEmergency MedicineA51595CALIFORNIANo
2208D00000XGeneral PracticeA51595CALIFORNIAYes

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
100A515950MEDICAIDCALIFORNIA

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: 11/21/2025

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