Healthcare Provider Details

I. General information

NPI: 1265463590
Provider Name (Legal Business Name): NGUYEN HUE NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 01/04/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3246 SEPULVEDA BLVD 204
TORRANCE CA
90505-2728
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 310-539-9579
  • Fax: 310-539-9582
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA24812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: