Healthcare Provider Details

I. General information

NPI: 1952756348
Provider Name (Legal Business Name): VAN NGUYEN RYE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28881 AIROSO ST UNIT 110
RANCHO MISSION VIEJO CA
92694-2487
US

IV. Provider business mailing address

1200 N STATE ST
LOS ANGELES CA
90089-1001
US

V. Phone/Fax

Practice location:
  • Phone: 949-304-1716
  • Fax:
Mailing address:
  • Phone: 323-409-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA153295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: