Healthcare Provider Details

I. General information

NPI: 1811647217
Provider Name (Legal Business Name): MINH NGUYEN DO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10945 LE CONTE AVE STE 2114
LOS ANGELES CA
90095-6949
US

IV. Provider business mailing address

10945 LE CONTE AVE STE 2114
LOS ANGELES CA
90095-3000
US

V. Phone/Fax

Practice location:
  • Phone: 310-206-0449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR.0075202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: