Healthcare Provider Details

I. General information

NPI: 1598272395
Provider Name (Legal Business Name): HA VI NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 S DOBSON RD STE 101
CHANDLER AZ
85224-5668
US

IV. Provider business mailing address

655 S DOBSON RD STE 101
CHANDLER AZ
85224-5668
US

V. Phone/Fax

Practice location:
  • Phone: 480-459-2555
  • Fax:
Mailing address:
  • Phone: 804-592-5554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number72523
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: