Individual ProviderMandy NguyenFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1190 Baker St Ste 100, Costa Mesa, CA 92626-4105(949) 791-3250PECOS EnrollmentBased on the most recent information from CMS, provider Mandy Nguyen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1548849979Provider TypeIndividualFull NameNguyen, MandyGenderFemaleSole ProprietorNoEnumeration Date4/4/2021Last Updated8/12/2024Contact InformationPractice LocationPractice Address1190 Baker St Ste 100, Costa Mesa, CA 92626-4105Phone(949) 791-3250FaxUnlisted FaxMailing LocationMailing Address1190 Baker St Ste 100, Costa Mesa, CA 92626-4105PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense20A21480California