Healthcare Provider Details

I. General information

NPI: 1750965448
Provider Name (Legal Business Name): CYRUS NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2021
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

101 THE CITY DR S
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5239
  • Fax: 714-456-5390
Mailing address:
  • Phone: 714-456-5239
  • Fax: 714-456-5390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA187225
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: