Healthcare Provider Details

I. General information

NPI: 1508220328
Provider Name (Legal Business Name): TRINH TUYET DAO NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 07/26/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 FAIR OAKS BLVD
SACRAMENTO CA
95825-4708
US

IV. Provider business mailing address

9169 BUCKEYE WAY
SACRAMENTO CA
95829-8723
US

V. Phone/Fax

Practice location:
  • Phone: 916-973-5000
  • Fax:
Mailing address:
  • Phone: 916-753-4272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA162225
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: