Healthcare Provider Details

I. General information

NPI: 1558001974
Provider Name (Legal Business Name): CHRISTINA NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N 1ST ST STE 120
FRESNO CA
93726-6818
US

IV. Provider business mailing address

2222 CHERRY STREET MOB 2, SUITE 2300, PEDIATRIC RESIDENCY OFFICE
TOLEDO OH
43608
US

V. Phone/Fax

Practice location:
  • Phone: 559-224-4365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR0075782
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA203805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: