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NPI Code Detail

MEDICARE: MIMI NGUYEN

MEDICARE: MIMI NGUYEN
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
1207N00000XDermatology PhysicianA178402CA

General Provider Information

NPI Number : 1770082943
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIMI NGUYEN
Provider Business Mailing Address
First Line : 2951 BENEFIT WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1272
Country : US
Telephone Number : 916-285-8165
Fax Number :
Provider Business Practice Location Address
First Line : 2951 BENEFIT WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1272
Country : US
Telephone Number : 916-285-8165
Fax Number : 916-285-8175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2018
Last Update Date : 10/10/2024

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Directions to “ MIMI NGUYEN ” Practice Location

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