Healthcare Provider Details

I. General information

NPI: 1982934337
Provider Name (Legal Business Name): JOSEPH T. NGUYEN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4332 KATELLA AVE
LOS ALAMITOS CA
90720-3564
US

IV. Provider business mailing address

PO BOX 1352
ORANGE CA
92856-0352
US

V. Phone/Fax

Practice location:
  • Phone: 562-430-1235
  • Fax: 562-430-1671
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH T NGUYEN
Title or Position: PRESIDENT
Credential: MD
Phone: 562-430-1236