Healthcare Provider Details

I. General information

NPI: 1730359530
Provider Name (Legal Business Name): HOANG TRAN NGUYEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2008
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16040 HARBOR BLVD #G
FOUNTAIN VALLEY CA
92708-1327
US

IV. Provider business mailing address

16040 HARBOR BLVD #G
FOUNTAIN VALLEY CA
92708-1327
US

V. Phone/Fax

Practice location:
  • Phone: 714-531-7930
  • Fax: 719-531-7997
Mailing address:
  • Phone: 714-531-7930
  • Fax: 719-531-7997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: HOANG TRAN NGUYEN
Title or Position: DORTOR
Credential: M.D
Phone: 714-531-7930