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KHANH BAO NGUYEN MD INC
NPI 1366756215
Family Medicine in Garden Grove, CA

Active since August 03, 2010CLIA 05D0995350 · Waiver
13830 BROOKHURST ST, GARDEN GROVE, CA 92843(714) 467-4330(714) 534-4575 Get Directions Write a Review

NPPES record last updated: April 10, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Khanh Bao Nguyen Md Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHANH BAO NGUYEN MD INC (NPI 1366756215) is a healthcare organization registered as a family medicine in Garden Grove, California and active in the NPI registry since August 2010. The organization holds a CLIA Waiver certificate valid through February 19, 2027 and lists Khanh Bao Nguyen, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1366756215
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKHANH BAO NGUYEN MD INC
Location Address13830 BROOKHURST STGarden Grove, CA 92843-3121
Mailing Address13830 Brookhurst StGarden Grove, CA 92843-3121 · (714) 467-4330 · Fax (714) 534-4575
Phone(714) 467-4330
Fax(714) 534-4575
Organization SubpartNo
Authorized OfficialKhanh Bao NguyenPresident/ceo · (714) 467-4330
Enumeration DateAugust 3, 2010
Last NPPES UpdateApril 10, 2013
✔ NPI 1366756215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
13830 BROOKHURST ST, Garden Grove, CA 92843
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Khanh Bao Nguyen Md Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Khanh Bao Nguyen MD Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Khanh Nguyen, M.D.
Family Practice
NPI 1548359474
13830 BROOKHURST ST
Garden Grove, CA 92843
(714) 467-4330
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0995350

Khanh Bao Nguyen, MD Inc · Garden Grove, CA
Active · expires Feb 19, 2027
CLIA Number05D0995350
Laboratory TypePhysician Office
Certificate Effective DateFebruary 20, 2025
Certificate Expiration DateFebruary 19, 2027
Laboratory DirectorKhanh B. Nguyen MD
Laboratory Phone(714) 467-4330
Laboratory LocationKhanh Bao Nguyen, MD Inc13830 Brookhurst St, Garden Grove, CA 92843
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khanh Bao Nguyen MD Inc's NPI number?

The NPI number for Khanh Bao Nguyen MD Inc is 1366756215. It was assigned to this organization in the NPPES registry on August 3, 2010.

Where is Khanh Bao Nguyen MD Inc located?

Khanh Bao Nguyen MD Inc is located at 13830 Brookhurst St, Garden Grove, CA 92843. The listed phone number is (714) 467-4330.

What is Khanh Bao Nguyen MD Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Khanh Bao Nguyen MD Inc enrolled in Medicare?

Yes. Khanh Bao Nguyen MD Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Khanh Bao Nguyen MD Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Khanh Bao Nguyen MD Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Khanh Bao Nguyen MD Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0995350) is associated with this NPI, valid through February 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Khanh Bao Nguyen MD Inc was last updated on April 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.