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280 Newport Center Dr Ste 110 Newport Beach CA 92660-7541 | |
| (702) 909-5903 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 280 Newport Center Dr Ste 110, Newport Beach, California |
| Authorized Official Name and Position | Andrew Nguyen (MANAGING PARTNER) |
| Authorized Official Contact | 7029095903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4680 Polaris Ave Ste 200 Las Vegas NV 89103-5600 Ph: (702) 909-6400 | 280 Newport Center Dr Ste 110 Newport Beach CA 92660-7541 Ph: (702) 909-5903 |
| NPI Number | 1164202396 |
|---|---|
| Provider Enumeration Date | 10/04/2023 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Medicare PECOS PAC ID | 5092168740 |
|---|---|
| Medicare Enrollment ID | O20240129003698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164202396 | NPI | - | NPPES |
| 1679004246 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Andrew A Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245760750 PECOS PAC ID: 8022340934 Enrollment ID: I20191025001906 |
| Provider Name | Nita Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881126258 PECOS PAC ID: 0547502080 Enrollment ID: I20230912001295 |
| Provider Name | Janet Seungmin Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679004246 PECOS PAC ID: 6204279060 Enrollment ID: I20240208001819 |
| Provider Name | Eric Zhuang |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1972008605 PECOS PAC ID: 8022442284 Enrollment ID: I20240607002056 |
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