Healthcare Provider Details

I. General information

NPI: 1356322861
Provider Name (Legal Business Name): THOMAS T. NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10904 REAGAN ST
LOS ALAMITOS CA
90720-2435
US

IV. Provider business mailing address

6100 WATERFORD DISTRICT DR STE 450
MIAMI FL
33126-4692
US

V. Phone/Fax

Practice location:
  • Phone: 562-596-3140
  • Fax:
Mailing address:
  • Phone: 888-787-1598
  • Fax: 714-795-6829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG72340
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: