Healthcare Provider Details

I. General information

NPI: 1023185030
Provider Name (Legal Business Name): RICHARD THE NGUYEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15965 LOS GATOS BLVD STE 201
LOS GATOS CA
95032-3415
US

IV. Provider business mailing address

15965 LOS GATOS BLVD STE 201
LOS GATOS CA
95032-3415
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-1855
  • Fax: 408-356-4183
Mailing address:
  • Phone: 408-358-1855
  • Fax: 408-356-4183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO1813
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20A10031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: