Healthcare Provider Details

I. General information

NPI: 1467194845
Provider Name (Legal Business Name): THAO HOAN NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 COMMERCE STE 200
IRVINE CA
92602-1362
US

IV. Provider business mailing address

310 COMMERCE STE 200
IRVINE CA
92602-1362
US

V. Phone/Fax

Practice location:
  • Phone: 888-878-5270
  • Fax:
Mailing address:
  • Phone: 888-878-5270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberA188027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: