Healthcare Provider Details

I. General information

NPI: 1497794093
Provider Name (Legal Business Name): MYHOANG P NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 CONTRA COSTA BLVD
PLEASANT HILL CA
94523-3054
US

IV. Provider business mailing address

1515 CONTRA COSTA BLVD
PLEASANT HILL CA
94523-3054
US

V. Phone/Fax

Practice location:
  • Phone: 925-671-2510
  • Fax:
Mailing address:
  • Phone: 925-671-2510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number00A693940
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: