Healthcare Provider Details

I. General information

NPI: 1821280264
Provider Name (Legal Business Name): HUY THUONG NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CARSON ST DEPARTMENT OF RADIOLOGY
TORRANCE CA
90509-2910
US

IV. Provider business mailing address

1000 CARSON ST, PO BOX 2910 DEPARTMENT OF RADIOLOGY BOX 27
TORRANCE CA
90509-2910
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2847
  • Fax: 310-618-9500
Mailing address:
  • Phone: 310-222-2847
  • Fax: 310-618-9500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA92726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: