Healthcare Provider Details

I. General information

NPI: 1215279971
Provider Name (Legal Business Name): TRUC-ANH THANH NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N. CAMPBELL AVE., ROOM 4401 P.O. BOX 245114
TUCSON AZ
85724
US

IV. Provider business mailing address

1501 N CAMPBELL AVE RM 4401
TUCSON AZ
85724-0001
US

V. Phone/Fax

Practice location:
  • Phone: 520-626-7221
  • Fax:
Mailing address:
  • Phone: 520-626-7221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD83416
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number146058
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number58900
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: