MEDICARE: THUONG T NGUYEN DPT

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	174400000X	Specialist	PT34404	CA

General Provider Information

NPI Number	:	1336325406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THUONG T NGUYEN DPT

Provider Business Mailing Address
First Line	:	7080 HOLLYWOOD BLVD
Second Line	:	815
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6906
Country	:	US
Telephone Number	:	323-957-9571
Fax Number	:	323-957-9583

Provider Business Practice Location Address
First Line	:	7080 HOLLYWOOD BLVD
Second Line	:	815
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6906
Country	:	US
Telephone Number	:	323-957-9571
Fax Number	:	323-957-9583

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

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	01/18/2008

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Directions to “ THUONG T NGUYEN DPT” Practice Location

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