Healthcare Provider Details

I. General information

NPI: 1073216727
Provider Name (Legal Business Name): DANIEL KHIEM NGUYEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 SAND CANYON AVE STE 245
IRVINE CA
92618-3744
US

IV. Provider business mailing address

8 SANTA CRUZ AISLE
IRVINE CA
92606-0814
US

V. Phone/Fax

Practice location:
  • Phone: 949-557-0380
  • Fax: 949-557-0381
Mailing address:
  • Phone: 949-383-7452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: