Healthcare Provider Details

I. General information

NPI: 1427684422
Provider Name (Legal Business Name): JULIAN HUAN NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9089 MESA WOODS AVE
SAN DIEGO CA
92126-2840
US

IV. Provider business mailing address

9089 MESA WOODS AVE
SAN DIEGO CA
92126-2840
US

V. Phone/Fax

Practice location:
  • Phone: 858-717-1939
  • Fax:
Mailing address:
  • Phone: 858-717-1939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE6222
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE6222
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: