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365 MEDICAL GROUP, INC
NPI 1780275016
Internal Medicine in Garden Grove, CA

Active since January 29, 2021CLIA 05D2220592 · Waiver
12865 MAIN ST STE 204, GARDEN GROVE, CA 92840(714) 360-0739 Get Directions Write a Review

NPPES record last updated: January 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 365 Medical Group, Inc NPPES

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

365 MEDICAL GROUP, INC (NPI 1780275016) is a healthcare organization registered as an internal medicine in Garden Grove, California and active in the NPI registry since January 2021. The organization holds a CLIA Waiver certificate valid through April 12, 2027 and lists Tan Nguyen, Owner, as its authorized official.

NPPES Registry Identity

NPI1780275016
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business Name365 MEDICAL GROUP, INC
Location Address12865 MAIN ST STE 204Garden Grove, CA 92840-8200
Mailing Address12865 Main St Ste 204Garden Grove, CA 92840-8200 · (714) 360-0739
Phone(714) 360-0739
Organization SubpartNo
Authorized OfficialTan NguyenOwner · (714) 360-0739
Enumeration DateJanuary 29, 2021
NPPES CertifiedJanuary 29, 2021
✔ NPI 1780275016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12865 MAIN ST STE 204, Garden Grove, CA 92840
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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

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 05D2220592

365 Medical Group, Inc. · Garden Grove, CA
Active · expires Apr 12, 2027
CLIA Number05D2220592
Laboratory TypePhysician Office
Certificate Effective DateApril 13, 2025
Certificate Expiration DateApril 12, 2027
Laboratory DirectorTan Nguyen
Laboratory Phone(714) 360-0739
Laboratory Location365 Medical Group, Inc.12865 Main St Ste 105, Garden Grove, CA 92840
CLIA data matches this NPI record on: 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 365 Medical Group, Inc's NPI number?

The NPI number for 365 Medical Group, Inc is 1780275016. It was assigned to this organization in the NPPES registry on January 29, 2021.

Where is 365 Medical Group, Inc located?

365 Medical Group, Inc is located at 12865 Main St Ste 204, Garden Grove, CA 92840. The listed phone number is (714) 360-0739.

What is 365 Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does 365 Medical Group, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2220592) is associated with this NPI, valid through April 12, 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 365 Medical Group, Inc was last updated on January 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.