Healthcare Provider Details

I. General information

NPI: 1982884359
Provider Name (Legal Business Name): HOA Q NGUYEN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15651 IMPERIAL HWY STE 102B
LA MIRADA CA
90638-1600
US

IV. Provider business mailing address

15651 IMPERIAL HWY STE 102B
LA MIRADA CA
90638-1600
US

V. Phone/Fax

Practice location:
  • Phone: 562-947-9591
  • Fax:
Mailing address:
  • Phone: 562-947-9591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA42958
License Number StateCA

VIII. Authorized Official

Name: DR. HOA NGUYEN
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 562-947-9591