| Phong Ky Nguyen, MD | |
|
350 Terracina Blvd, Redlands, CA 92373-4850 | |
| (909) 335-5500 | |
| Not Available |
| Full Name | Phong Ky Nguyen |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 350 Terracina Blvd, Redlands, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770699506 | NPI | - | NPPES |
| 00A515950 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | A51595 (California) | Secondary |
| 208D00000X | General Practice | A51595 (California) | Primary |
| Entity Name | Cep America - California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023063542 PECOS PAC ID: 6103739131 Enrollment ID: O20031106000520 |
| Entity Name | Medamerica Physician Solutions Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487237111 PECOS PAC ID: 8729221809 Enrollment ID: O20130821001035 |
| Entity Name | Cep America - Auc Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568861524 PECOS PAC ID: 9537481692 Enrollment ID: O20141201002085 |
| Entity Name | Bl Anderson Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821627639 PECOS PAC ID: 5395176473 Enrollment ID: O20200505000497 |
| Entity Name | Rehab Labs |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841920253 PECOS PAC ID: 6901278803 Enrollment ID: O20230201003109 |
| Mailing Address | Practice Location Address |
|---|---|
| Phong Ky Nguyen, MD 2100 Powell St, Ste 900, Emeryville, CA 94608-1826 Ph: (510) 350-2600 | Phong Ky Nguyen, MD 350 Terracina Blvd, Redlands, CA 92373-4850 Ph: (909) 335-5500 |
Deborah Lee Behringer, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 350 Terracina Blvd, Bangasser Wound Care Center, Redlands, CA 92373 Phone: 909-478-6731 | |
Kimberly Elyse Conley, M.D. General Practice Medicare: Medicare Enrolled Practice Location: 1889 W Redlands Blvd Bldg 9, Redlands, CA 92373 Phone: 909-501-5167 | |
Joseph Gerald Hudson, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 1325 La Arriba Dr, Redlands, CA 92373 Phone: 909-307-6385 | |
Berta Margarita Rubio, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 12 Nevada St, Ste A, Redlands, CA 92373 Phone: 909-307-8503 |