| Lorphen Medical | |
|
3151 Airway Ave Ste T3 Costa Mesa CA 92626-4627 | |
| (949) 689-9754 | |
| (714) 545-5748 |
| Full Name | Lorphen Medical |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3151 Airway Ave Ste T3, Costa Mesa, California |
| Authorized Official Name and Position | Charles Tuan-tu Song Nguyen (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 9496899754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lorphen Medical 6 Coloma Irvine CA 92602-2438 Ph: (949) 689-9754 | Lorphen Medical 3151 Airway Ave Ste T3 Costa Mesa CA 92626-4627 Ph: (949) 689-9754 |
| NPI Number | 1891948717 |
|---|---|
| Provider Enumeration Date | 10/23/2008 |
| Last Update Date | 02/23/2012 |
| Medicare PECOS PAC ID | 9436227121 |
|---|---|
| Medicare Enrollment ID | O20081008000271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891948717 | NPI | - | NPPES |
| A69542 | Other | CA | STATE LECENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A69542 (California) | Primary |
| Provider Name | Charles Tuan-tu S Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942380118 PECOS PAC ID: 4688607906 Enrollment ID: I20050915001194 |
| Provider Name | Samantha J Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790023281 PECOS PAC ID: 5890929236 Enrollment ID: I20150831000820 |
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