Healthcare Provider Details

I. General information

NPI: 1720205768
Provider Name (Legal Business Name): ANH VIETNAM NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 SEPULVEDA BLVD
TORRANCE CA
90505
US

IV. Provider business mailing address

3250 SEPULVEDA BLVD
TORRANCE CA
90505
US

V. Phone/Fax

Practice location:
  • Phone: 310-534-3231
  • Fax: 310-534-3287
Mailing address:
  • Phone: 310-534-3231
  • Fax: 310-534-3287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA96730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: