Healthcare Provider Details

I. General information

NPI: 1811077787
Provider Name (Legal Business Name): THUY THANH NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9550 BOLSA AVE. SUITE 101
WESTMINSTER CA
92683
US

IV. Provider business mailing address

9550 BOLSA AVE. SUITE 101
WESTMINSTER CA
92683
US

V. Phone/Fax

Practice location:
  • Phone: 714-775-1628
  • Fax: 714-775-5218
Mailing address:
  • Phone: 714-775-1628
  • Fax: 714-775-5218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA62612
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA62612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: