Healthcare Provider Details

I. General information

NPI: 1275609844
Provider Name (Legal Business Name): MINH NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14120 BEACH BLVD STE 104
WESTMINSTER CA
92683-4454
US

IV. Provider business mailing address

14120 BEACH BLVD STE 104
WESTMINSTER CA
92683-4454
US

V. Phone/Fax

Practice location:
  • Phone: 714-896-7429
  • Fax:
Mailing address:
  • Phone: 714-896-7429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License NumberRHP73117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: