Healthcare Provider Details

I. General information

NPI: 1356199251
Provider Name (Legal Business Name): VINHBOI NGUYEN RPSGT.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

6324 GERANIUM CT
WESTMINSTER CA
92683-3602
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax: 562-346-3475
Mailing address:
  • Phone: 909-451-1225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number2958
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: