Healthcare Provider Details

I. General information

NPI: 1447275631
Provider Name (Legal Business Name): HA SON NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13481 EUCLID ST STE A
GARDEN GROVE CA
92843-2546
US

IV. Provider business mailing address

1951 PACIFIC AVE
LONG BEACH CA
90806-5321
US

V. Phone/Fax

Practice location:
  • Phone: 714-468-6755
  • Fax:
Mailing address:
  • Phone: 562-218-8778
  • Fax: 562-218-1916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG67118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: