Healthcare Provider Details

I. General information

NPI: 1720169832
Provider Name (Legal Business Name): CHAU TUAN NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3170 LOMA VISTA RD SUITE B
VENTURA CA
93003-2970
US

IV. Provider business mailing address

6294 CANARY ST
VENTURA CA
93003-0221
US

V. Phone/Fax

Practice location:
  • Phone: 805-641-4431
  • Fax: 805-641-4416
Mailing address:
  • Phone: 714-290-9807
  • Fax: 805-641-4416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA88001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: