Healthcare Provider Details

I. General information

NPI: 1164521563
Provider Name (Legal Business Name): HAN TRAN NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W NORTH MARKEL BLVD SUITE 100 NORTHGATE POINT RST
SACRAMENTO CA
95834
US

IV. Provider business mailing address

601 W NORTH MARKEL BLVD STE 100 NORTHGATE POINT RST
SACRAMENTO CA
95834
US

V. Phone/Fax

Practice location:
  • Phone: 916-567-4222
  • Fax: 916-567-4220
Mailing address:
  • Phone: 916-567-4222
  • Fax: 916-567-4220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC50552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: