Healthcare Provider Details

I. General information

NPI: 1982771697
Provider Name (Legal Business Name): TUAN H NGUYEN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9842 BOLSA AVE STE 200
WESTMINSTER CA
92683-6685
US

IV. Provider business mailing address

9842 BOLSA AVE STE 200
WESTMINSTER CA
92683-6685
US

V. Phone/Fax

Practice location:
  • Phone: 714-979-1445
  • Fax: 714-979-1422
Mailing address:
  • Phone: 714-979-1445
  • Fax: 714-979-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number20A7361
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20A7361
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: