Healthcare Provider Details

I. General information

NPI: 1811135627
Provider Name (Legal Business Name): Y VIEN TRAN NGUYEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27700 MEDICAL CENTER RD
MISSION VIEJO CA
92691-6426
US

IV. Provider business mailing address

28202 CABOT RD STE 300
LAGUNA NIGUEL CA
92677-1249
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-7744
  • Fax:
Mailing address:
  • Phone: 949-365-5765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number20A12652
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20A12652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: