Healthcare Provider Details

I. General information

NPI: 1558421883
Provider Name (Legal Business Name): ANTHONY H NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 HOSPITAL DR STE 212
MOUNTAIN VIEW CA
94040-4125
US

IV. Provider business mailing address

127 KELLOGG WAY
SANTA CLARA CA
95051-6710
US

V. Phone/Fax

Practice location:
  • Phone: 650-962-4536
  • Fax: 650-962-4533
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberA068674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: