Healthcare Provider Details

I. General information

NPI: 1306223730
Provider Name (Legal Business Name): HIEU TRUNG NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 SAN JOSE ST
SALINAS CA
93901-3901
US

IV. Provider business mailing address

260 SAN JOSE ST
SALINAS CA
93901-3901
US

V. Phone/Fax

Practice location:
  • Phone: 831-757-8124
  • Fax:
Mailing address:
  • Phone: 831-757-8124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA153424
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301108055
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: