Healthcare Provider Details

I. General information

NPI: 1700060480
Provider Name (Legal Business Name): DUC ANNIE MINH NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S DOBSON RD # 2
CHANDLER AZ
85224-5678
US

IV. Provider business mailing address

625 N PLAZA DR
APACHE JUNCTION AZ
85120-5502
US

V. Phone/Fax

Practice location:
  • Phone: 480-385-5055
  • Fax: 480-385-5054
Mailing address:
  • Phone: 833-431-4449
  • Fax: 480-983-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42787
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: