Healthcare Provider Details

I. General information

NPI: 1144498569
Provider Name (Legal Business Name): TUAN NGOC NGUYEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28078 BAXTER RD STE 320
MURRIETA CA
92563-1404
US

IV. Provider business mailing address

28078 BAXTER RD STE 320
MURRIETA CA
92563-1404
US

V. Phone/Fax

Practice location:
  • Phone: 951-246-4546
  • Fax: 951-672-9036
Mailing address:
  • Phone: 951-246-4546
  • Fax: 951-672-9036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA64605
License Number StateCA

VIII. Authorized Official

Name: DR. TUAN NGOC NGUYEN
Title or Position: PRESIDENT
Credential:
Phone: 951-246-4546