Healthcare Provider Details

I. General information

NPI: 1730376914
Provider Name (Legal Business Name): HA HONG NGUYEN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HA HONG NGUYEN RNP

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1994 PALOMA ST.
PASADENA CA
91104-4819
US

IV. Provider business mailing address

1994 PALOMA ST.
PASADENA CA
91104-4819
US

V. Phone/Fax

Practice location:
  • Phone: 626-264-0811
  • Fax:
Mailing address:
  • Phone: 626-264-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number12382
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code282NW0100X
TaxonomyWomen's Hospital
License Number525894
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License Number14919
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: