TAN KHAC NGUYEN (NPI# 1144273491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144273491 |
| Entity Type | Individual |
| Full Name | TAN KHAC NGUYEN |
| Credential | M.D. |
| Practice Address |
1310 San Bernardino Rd Suite 207 Upland CA 91786-4979 |
| Practice Telephone | 9099468600 |
| Practice Fax Number | 9099468604 |
| Mailing Telephone | 9099468600 |
| Mailing Fax Number | 9099468604 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2011-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | A70331 | CA | Allopathic & Osteopathic Physicians |
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
A70331 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILLROAD MEDICARE | P00614352 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063919546 | Tan Thanh Nguyen | Pharmacist | 580 Bailey Rd Bay Point, Bay Point, CA 94565-4304 | 2018-04-10 |
| 1255849147 | Tan Minh Nguyen | Physical Therapy Assistant | 1341 Blalock, Houston, TX 77055 | 2018-01-13 |
| 1477998557 | Tan Tri Nguyen | Chiropractor | 18805 Cox Ave Ste 170, Saratoga, CA 95070-4162 | 2013-05-03 |
| 1477845972 | Tan Duy Nguyen | Physical Therapist | 14201 Nordhoff St Apt E1, Panorama City, CA 91402-1934 | 2011-05-03 |
| 1316163942 | Tan Minh Nguyen | Radiology | 273 E Glenarm St Apt 8, Pasadena, CA 91106-4239 | 2007-04-18 |
| 1831227545 | Tan Thach Nguyen | Pathology | Wramc, Bldg 2, Dpals, 6900 Georgia Ave. Nw, Washington, DC 20307-5001 | 2007-03-02 |
| 1639106107 | Tan Duong Nguyen | Otolaryngology | 1100 E Dove Ave Ste 402, Mcallen, TX 78504-4684 | 2006-06-28 |
| 1609839299 | Tan The Nguyen | Internal Medicine | 508 S Brookhurst St, Anaheim, CA 92804 | 2006-04-06 |
| 1093705485 | Tan V Nguyen | Family Medicine | 2400 Del Paso Rd, #145, Sacramento, CA 95834-9627 | 2005-10-26 |
| 1548893969 | Tan Nguyen | Pharmacist | 4707 Fleur Dr, Des Moines, IA 50321-2335 | 2020-02-13 |
| Street Address |
1310 SAN BERNARDINO RD SUITE 207 |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-4979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921830 | Lionel Bernard Katchem | Family Medicine | 1310 San Bernardino Rd, Ste 105, Upland, CA 91786-4979 | 2005-06-09 |
| 1023493095 | Madonna Zand | Nurse Practitioner | 1310 San Bernardino Rd, 205, Upland, CA 91786-4979 | 2015-07-20 |
| 1023406725 | Ian Joseph Donahue | Physician Assistant | 1310 San Bernardino Rd, Ste. 103, Upland, CA 91786-4979 | 2015-01-03 |
| 1811395221 | Noralyne Eini | Nurse Practitioner | 1310 San Bernardino Rd, Suite 105, Upland, CA 91786-4979 | 2014-12-17 |
| 1134522501 | Amanda Ingalls | Physician Assistant | 1310 San Bernardino Rd, Suite 101, Upland, CA 91786-4979 | 2014-09-30 |
| 1205265931 | Lorraine Mae Dominick | Nurse Practitioner | 1310 San Bernardino Rd, Upland, CA 91786-4979 | 2013-11-04 |
| 1194028423 | Advanced Skin Clinic & Surgery, PC | Dermatology | 1310 San Bernardino Rd, Suite 207, Upland, CA 91786-4979 | 2010-12-08 |
| 1871747428 | Care for Womens Medical Group Inc | Obstetrics & Gynecology | 1310 San Bernardino Rd, Suite 201, Upland, CA 91786-4979 | 2008-11-10 |
| 1356502116 | Dalia Ibrahim-abdelaziz | Internal Medicine | 1310 San Bernardino Rd, Ste 103, Upland, CA 91786-4979 | 2008-06-24 |
| 1992917108 | Jeffrey D Ries D O A Professional Corporation | Psychiatry & Neurology | 1310 San Bernardino Rd, Ste 101, Upland, CA 91786-4985 | 2007-05-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134380330 | Andrea Paola Passalacqua | Dermatology | 886 W Foothill Blvd Ste G, Upland, CA 91786-3780 | 2008-06-19 |
| 1255421335 | Diem Quynh Pham | Dermatology | 954 W Foothill Blvd Ste B, Upland, CA 91786 | 2006-10-13 |
| 1922051739 | Charles M. Tran | Dermatology | 585 N Mountain Ave, Suite A, Upland, CA 91786-8516 | 2006-05-19 |
| 1699836288 | Gloria Jane Stevens | Dermatology | 954 W Foothill Blvd Ste B, Upland, CA 91786 | 2006-12-13 |
| 1245391820 | Ronald Demetri Liskanich | Dermatology | 954 W Foothill Blvd Ste B, Upland, CA 91786 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578175006 | Lms Medical Services | Dermatology | 1118 N Mccadden Pl, Los Angeles, CA 90038-1213 | 2020-08-17 |
| 1932687241 | Silhouette Medical Group | Dermatology | 101 E Vineyard Ave Ste 107, Livermore, CA 94550-6877 | 2018-07-31 |
| 1780188482 | California Dermatology Physicians | Dermatology | 1902 Fullerton Ave # 102, Corona, CA 92881-3112 | 2018-03-19 |
| 1942709738 | Azadeh Shirazi Md Inc | Dermatology | 7301 Girard Ave Ste 202, La Jolla, CA 92037-5151 | 2018-02-07 |
| 1205342920 | Solano Dermatology Associates Inc | Dermatology | 1700 2nd St Ste 220, Napa, CA 94559-2455 | 2017-12-18 |
| 1831603901 | Laser Medspa, Inc. | Dermatology | 73655 El Paseo Ste N, Palm Desert, CA 92260-4304 | 2017-11-27 |
| 1326427204 | Jennifer Herrmann Md Inc | Dermatology | 421 N Rodeo Dr Ste 7, Beverly Hills, CA 90210-4514 | 2015-05-25 |
| 1235540196 | Microsurgery Goup | Dermatology | 21039 S Figueroa Ave Suite 201, Carson, CA 90745-7042 | 2014-05-14 |
| 1811261183 | Robert Ray Nettles | Dermatology | 8500 Wilshire Blvd Ste 630, Beverly Hills, CA 90211-3139 | 2012-03-02 |
| 1164748737 | Jane Chung | Dermatology | 895 E Fremont Ave Ste 201, Sunnyvale, CA 94087-2973 | 2010-04-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.