MEDICARE: DR. VINH QUY NGUYEN M.D.

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	207R00000X	Internal Medicine Physician	G053256	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	:	1720086556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINH QUY NGUYEN M.D.

Provider Business Mailing Address
First Line	:	200 JOSE FIGUERES AVE
Second Line	:	SUITE 460
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1593
Country	:	US
Telephone Number	:	408-254-1794
Fax Number	:	408-254-7284

Provider Business Practice Location Address
First Line	:	200 JOSE FIGUERES AVE
Second Line	:	SUITE 460
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1500
Country	:	US
Telephone Number	:	408-254-1794
Fax Number	:	408-254-7284

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	06/06/2012

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