MEDICARE: RICHARD D NGUYEN MD

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	207Q00000X	Family Medicine Physician	A85614	CA
2	207Q00000X	Family Medicine Physician	ME105937	FL

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
2	1942235528	OTHER	CA	COMMHLTHCNTRS, SANTA MARIA NPI#

General Provider Information

NPI Number	:	1942235528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD D NGUYEN MD

Provider Business Mailing Address
First Line	:	8715 HENDERSON RD
Second Line	:	REN 4, #237
City	:	TAMPA
State	:	FL
Zip	:	33634-1143
Country	:	US
Telephone Number	:	813-206-7515
Fax Number	:

Provider Business Practice Location Address
First Line	:	8715 HENDERSON RD
Second Line	:	REN 4, #237
City	:	TAMPA
State	:	FL
Zip	:	33634-1143
Country	:	US
Telephone Number	:	813-206-7515
Fax Number	:

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/19/2013

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