MEDICARE: MS. GINA G NGUYEN NP

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	363LP2300X	Primary Care Nurse Practitioner	15330	CA
2	363LF0000X	Family Nurse Practitioner	NP 15330	CA

General Provider Information

NPI Number	:	1437158987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GINA G NGUYEN NP

Provider Business Mailing Address
First Line	:	323 N EUCLID ST
Second Line	:	SPC 136
City	:	SANTA ANA
State	:	CA
Zip	:	92703-3045
Country	:	US
Telephone Number	:	714-721-7951
Fax Number	:

Provider Business Practice Location Address
First Line	:	10507 GARDEN GROVE BLVD
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1128
Country	:	US
Telephone Number	:	714-721-7951
Fax Number	:

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	06/29/2020

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