| Ct Clinic | |
|
12221 Brookhurst St Ste 100 Garden Grove CA 92840-2848 | |
| (714) 805-8260 | |
| (714) 908-8086 |
| Full Name | Ct Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 12221 Brookhurst St Ste 100, Garden Grove, California |
| Authorized Official Name and Position | Tam K Nguyen (CEO/PRESIDENT) |
| Authorized Official Contact | 7147573797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ct Clinic 12221 Brookhurst St Ste 100 Garden Grove CA 92840-2848 Ph: (714) 805-8260 | Ct Clinic 12221 Brookhurst St Ste 100 Garden Grove CA 92840-2848 Ph: (714) 805-8260 |
| NPI Number | 1396011367 |
|---|---|
| Provider Enumeration Date | 03/23/2012 |
| Last Update Date | 04/22/2023 |
| Medicare PECOS PAC ID | 8022278001 |
|---|---|
| Medicare Enrollment ID | O20120328000946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396011367 | NPI | - | NPPES |
| HA55858 | Medicaid | CA |
| Provider Name | Tam Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720153182 PECOS PAC ID: 6305917485 Enrollment ID: I20120328000989 |
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