MEDICARE: CHRISTINE NGUYEN D.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	291160	CA

General Provider Information

NPI Number	:	1093174799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE NGUYEN D.P.T.

Provider Business Mailing Address
First Line	:	4482 BARRANCA PKWY STE 195
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92604-4706
Country	:	US
Telephone Number	:	949-679-3337
Fax Number	:	949-679-3336

Provider Business Practice Location Address
First Line	:	2820 N BELLFLOWER BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-1125
Country	:	US
Telephone Number	:	562-384-4525
Fax Number	:	562-384-4524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	02/23/2016

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