Healthcare Provider Details

I. General information

NPI: 1780605113
Provider Name (Legal Business Name): JON T NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3943 IRVINE BLVD # 252
IRVINE CA
92602-2400
US

IV. Provider business mailing address

3943 IRVINE BLVD # 252
IRVINE CA
92602-2400
US

V. Phone/Fax

Practice location:
  • Phone: 714-922-0120
  • Fax: 949-919-7690
Mailing address:
  • Phone: 714-922-0120
  • Fax: 949-919-7690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA77460
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: