Healthcare Provider Details

I. General information

NPI: 1649189622
Provider Name (Legal Business Name): KEN D. NGUYEN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 N HILL ST STE 16
LOS ANGELES CA
90012-2352
US

IV. Provider business mailing address

PO BOX 597
TEMPLE CITY CA
91780-0597
US

V. Phone/Fax

Practice location:
  • Phone: 626-888-8616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: KEN D NGUYEN
Title or Position: PRESIDENT
Credential: MD
Phone: 626-898-4560