Healthcare Provider Details

I. General information

NPI: 1255717823
Provider Name (Legal Business Name): ROBERT T. NGUYEN M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 COMMERCE STE 200
IRVINE CA
92602
US

IV. Provider business mailing address

310 COMMERCE STE 200
IRVINE CA
92602-1362
US

V. Phone/Fax

Practice location:
  • Phone: 714-921-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA156371
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: