Healthcare Provider Details

I. General information

NPI: 1487340139
Provider Name (Legal Business Name): AN-THU NGUYEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 N 44TH ST
PHOENIX AZ
85018-6461
US

IV. Provider business mailing address

3311 N 44TH ST
PHOENIX AZ
85018-6461
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-7360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number011428
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: