Healthcare Provider Details

I. General information

NPI: 1730224718
Provider Name (Legal Business Name): VUONG H. NGUYEN, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10141 WESTMINSTER AVE
GARDEN GROVE CA
92843-4788
US

IV. Provider business mailing address

16079 MESQUITE CIR
FOUNTAIN VALLEY CA
92708-1513
US

V. Phone/Fax

Practice location:
  • Phone: 714-467-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA69222
License Number StateCA

VIII. Authorized Official

Name: VUONG H NGUYEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-334-3324