Healthcare Provider Details

I. General information

NPI: 1942380118
Provider Name (Legal Business Name): CHARLES TUAN-TU SONG NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SALTON
IRVINE CA
92602-2425
US

IV. Provider business mailing address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

V. Phone/Fax

Practice location:
  • Phone: 909-610-9524
  • Fax: 909-367-2922
Mailing address:
  • Phone: 562-826-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number000000A69542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: