Healthcare Provider Details

I. General information

NPI: 1922135086
Provider Name (Legal Business Name): HOANG-CHUONG NGUYEN VU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 WARNER AVE STE 162
FOUNTAIN VALLEY CA
92708-7510
US

IV. Provider business mailing address

9681 GARDEN GROVE BLVD STE 104
GARDEN GROVE CA
92844-1548
US

V. Phone/Fax

Practice location:
  • Phone: 714-432-1212
  • Fax: 714-462-1213
Mailing address:
  • Phone: 714-462-6062
  • Fax: 714-462-6072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA75777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: