Healthcare Provider Details

I. General information

NPI: 1164959185
Provider Name (Legal Business Name): TUAN DANG NGUYEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8102 WESTMINSTER BLVD STE E
WESTMINSTER CA
92683-3363
US

IV. Provider business mailing address

18627 BROOKHURST ST # 530
FOUNTAIN VALLEY CA
92708-6748
US

V. Phone/Fax

Practice location:
  • Phone: 714-808-3080
  • Fax:
Mailing address:
  • Phone: 714-808-3080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberS4200
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberS4200
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number20A18461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: