MEDICARE: DOANH ANDREW NGUYEN A PROFESSIONAL CORP

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	G80814	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548473614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOANH ANDREW NGUYEN A PROFESSIONAL CORP

Provider Business Mailing Address
First Line	:	10760 WARNER AVE STE 201
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-3857
Country	:	US
Telephone Number	:	714-593-5356
Fax Number	:	714-593-5366

Provider Business Practice Location Address
First Line	:	10760 WARNER AVE STE 201
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-3857
Country	:	US
Telephone Number	:	714-593-5356
Fax Number	:	714-593-5366

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. DOANH ANDREW NGUYEN
Credential	:	M.D.
Telephone Number	:	714-593-5356

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	11/02/2022

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