| Tony Tan Nguyen Md Inc | |
|
302 Washington St #116 San Diego CA 92103-2110 | |
| (866) 284-2771 | |
| (800) 334-1041 |
| Full Name | Tony Tan Nguyen Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 302 Washington St, San Diego, California |
| Authorized Official Name and Position | Tan The Nguyen (OWNER) |
| Authorized Official Contact | 8587541114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tony Tan Nguyen Md Inc 302 Washington St #116 San Diego CA 92103-2110 Ph: (858) 754-1114 | Tony Tan Nguyen Md Inc 302 Washington St #116 San Diego CA 92103-2110 Ph: (866) 284-2771 |
| NPI Number | 1235216417 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 09/29/2014 |
| Medicare PECOS PAC ID | 2668533324 |
|---|---|
| Medicare Enrollment ID | O20081212000617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235216417 | NPI | - | NPPES |
| 00G671191 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Parvathi Tiruviluamala |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1982798948 PECOS PAC ID: 6406825579 Enrollment ID: I20040927000709 |
| Provider Name | Tan The Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609839299 PECOS PAC ID: 7810995362 Enrollment ID: I20081212000602 |
| Provider Name | Katia Suarez Berumen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487182093 PECOS PAC ID: 2365862596 Enrollment ID: I20201008003267 |
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