Healthcare Provider Details

I. General information

NPI: 1275321473
Provider Name (Legal Business Name): DINH T NGUYEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DINH TRUONG NGUYEN
Title or Position: PRESIDENT
Credential: MD
Phone: 714-462-6062