DR. ANDREW NGUYEN HOANG (DO) – Family Medicine Physician, NPI 1073257481

DR. ANDREW NGUYEN HOANG (DO) is a healthcare provider. based in San diego, California. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 20A23374 (CA). The NPI Number for DR. ANDREW NGUYEN HOANG (DO) is 1073257481

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANDREW NGUYEN HOANG (DO)
NPI
1073257481
Phone
(858) 740-9939
Address
11590 CYPRESS CANYON PARK DR
Enumeration Date
21 April 2022
Last Update Date
2 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6269194333259
Graduation Year
2022 (4 years ago)
PAC ID
3476031915
Group Practice PAC ID
9234041765
Professional Enrollment ID
I20260127003921
Address ID
CA917903001WE420XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

13,194 FAMILY PRACTICE in CA

Provider Addresses for DR. ANDREW NGUYEN HOANG (DO)

  • 11590 CYPRESS CANYON PARK DR

    SAN DIEGO, CA 921313582

    Phone: (858) 740-9939

    Type: Mailing

  • 1115 S SUNSET AVE

    WEST COVINA, CA 917903940

    Phone: (626) 962-4011

    Type: Location

  • 4991 ADERA ST

    MONTCLAIR, CA 917636147

    Phone: (858) 740-9939

    Type: Mailing

  • 420 S GLENDORA AVE

    WEST COVINA, CA 917903001

    Phone: (626) 919-4333

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-01-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260127003921IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92131)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234041765View full group profile
NameSpecialtyState
Family PracticeRI
Family PracticeCA
Family PracticeCA
O P T O M E T R YCA
Nurse PractitionerCA
Physician AssistantCA
Physician AssistantCA
Family PracticeCA
Family PracticeCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

Is DR. ANDREW NGUYEN HOANG (DO) listed with a National Provider Identifier?
Yes — DR. ANDREW NGUYEN HOANG (DO) has NPI 1073257481 on file in the registry.
Is DR. ANDREW NGUYEN HOANG (DO) still an active registrant?
DR. ANDREW NGUYEN HOANG (DO) carries an active NPI according to the public dataset.
What expertise is attributed to DR. ANDREW NGUYEN HOANG (DO)?
DR. ANDREW NGUYEN HOANG (DO)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. ANDREW NGUYEN HOANG (DO)?
Travel planning: use San Diego, California as the reference point for DR. ANDREW NGUYEN HOANG (DO), then confirm.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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