Healthcare Provider Details

I. General information

NPI: 1639751746
Provider Name (Legal Business Name): ALEXANDER DUNG NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE # S436
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

26800 CROWN VALLEY PKWY STE 310
MISSION VIEJO CA
92691-8020
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1297
  • Fax:
Mailing address:
  • Phone: 714-937-2155
  • Fax: 714-634-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA200299
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA200299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: