Healthcare Provider Details

I. General information

NPI: 1740580992
Provider Name (Legal Business Name): HOA NGUYEN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 WESTMINSTER BLVD SUITE A
WESTMINSTER CA
92683-9109
US

IV. Provider business mailing address

5835 WESTMINSTER BLVD SUITE A
WESTMINSTER CA
92683-9109
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-9770
  • Fax: 714-373-3361
Mailing address:
  • Phone: 714-898-9770
  • Fax: 714-373-3361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG58722
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG58722
License Number StateCA

VIII. Authorized Official

Name: DR. HOA NGUYEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-898-9770