Phong Ky Nguyen, MD | |
350 Terracina Blvd, Redlands, CA 92373-4850 | |
(909) 335-5500 | |
Not Available |
Full Name | Phong Ky Nguyen |
---|---|
Gender | Male |
Speciality | General Practice |
Location | 350 Terracina Blvd, Redlands, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770699506 | NPI | - | NPPES |
00A515950 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | A51595 (California) | Secondary |
208D00000X | General Practice | A51595 (California) | Primary |
Entity Name | Cep America - California |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023063542 PECOS PAC ID: 6103739131 Enrollment ID: O20031106000520 |
Entity Name | Medamerica Physician Solutions Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487237111 PECOS PAC ID: 8729221809 Enrollment ID: O20130821001035 |
Entity Name | Cep America - Auc Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568861524 PECOS PAC ID: 9537481692 Enrollment ID: O20141201002085 |
Entity Name | Bl Anderson Medical Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821627639 PECOS PAC ID: 5395176473 Enrollment ID: O20200505000497 |
Entity Name | Rehab Labs |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841920253 PECOS PAC ID: 6901278803 Enrollment ID: O20230201003109 |
Mailing Address | Practice Location Address |
---|---|
Phong Ky Nguyen, MD 2100 Powell St, Ste 900, Emeryville, CA 94608-1826 Ph: (510) 350-2600 | Phong Ky Nguyen, MD 350 Terracina Blvd, Redlands, CA 92373-4850 Ph: (909) 335-5500 |
Kimberly Elyse Conley, M.D. General Practice Medicare: Medicare Enrolled Practice Location: 1889 W Redlands Blvd Bldg 9, Redlands, CA 92373 Phone: 909-501-5167 | |
Joseph Gerald Hudson, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 1325 La Arriba Dr, Redlands, CA 92373 Phone: 909-307-6385 | |
Berta Margarita Rubio, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 12 Nevada St, Ste A, Redlands, CA 92373 Phone: 909-307-8503 |