Healthcare Provider Details

I. General information

NPI: 1497889158
Provider Name (Legal Business Name): NHAN HOA COMPRENESIVE HEALTH CARE CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7761 GARDEN GROVE BLVD.
GARDEN GROVE CA
92841-4200
US

IV. Provider business mailing address

7761 GARDEN GROVE BLVD.
GARDEN GROVE CA
92841-4200
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-8888
  • Fax: 714-901-7580
Mailing address:
  • Phone: 714-898-8888
  • Fax: 714-901-7580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number060000324
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number060000324
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number060000324
License Number StateCA

VIII. Authorized Official

Name: JENNY QUYNH NGUYEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 714-898-8888