Healthcare Provider Details

I. General information

NPI: 1437464997
Provider Name (Legal Business Name): DR. ANDREW NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 461
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1000 W CARSON ST # 461
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2700
  • Fax: 310-533-1841
Mailing address:
  • Phone: 310-222-2700
  • Fax: 310-533-1841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA120107
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA120107
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: