Healthcare Provider Details

I. General information

NPI: 1457351090
Provider Name (Legal Business Name): SERENA YOUNG-NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E 28TH ST STE 117
LONG BEACH CA
90806-2772
US

IV. Provider business mailing address

701 E 28TH ST STE 117
LONG BEACH CA
90806-2772
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-9890
  • Fax: 562-426-7809
Mailing address:
  • Phone: 562-426-9890
  • Fax: 562-426-7809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG48372
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: