Healthcare Provider Details

I. General information

NPI: 1730406729
Provider Name (Legal Business Name): ALEXANDER H. NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S AKERS ST STE 120
VISALIA CA
93277-8306
US

IV. Provider business mailing address

384 PEARSON DR
PORTERVILLE CA
93257-3368
US

V. Phone/Fax

Practice location:
  • Phone: 559-625-4118
  • Fax: 559-625-6004
Mailing address:
  • Phone: 559-788-1022
  • Fax: 559-793-4288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA172357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: