| Derek Nguyen Md Inc | |
|
4435 Brockton Ave Ste B Riverside CA 92501-4004 | |
| (951) 683-6830 | |
| (951) 228-9458 |
| Full Name | Derek Nguyen Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4435 Brockton Ave Ste B, Riverside, California |
| Authorized Official Name and Position | Derek Hoa Thanh Nguyen (OWNER) |
| Authorized Official Contact | 9516836830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Derek Nguyen Md Inc 4435 Brockton Ave Ste B Riverside CA 92501-4004 Ph: (951) 683-6830 | Derek Nguyen Md Inc 4435 Brockton Ave Ste B Riverside CA 92501-4004 Ph: (951) 683-6830 |
| NPI Number | 1700184280 |
|---|---|
| Provider Enumeration Date | 03/07/2011 |
| Last Update Date | 09/07/2022 |
| Medicare PECOS PAC ID | 2567648769 |
|---|---|
| Medicare Enrollment ID | O20110524000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700184280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A87744 (California) | Primary |
| Provider Name | Derek Hoa-thanh Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528054095 PECOS PAC ID: 1759331291 Enrollment ID: I20050124000257 |
| Provider Name | Simone Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386999167 PECOS PAC ID: 6507166923 Enrollment ID: I20160212001921 |
| Provider Name | Tien D Vo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912460353 PECOS PAC ID: 6103209838 Enrollment ID: I20220812002992 |
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