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General NPI Number Information
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NPI Number | 1013476878
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Entity Type | Individual
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Provider Name | QUOC-HAN NGUYEN
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Gender | Male
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1524 MCHENRY AVE STE 420
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City | MODESTO
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State | CA
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Zip | 95350-4567
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Country | US
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Telephone | 209-577-4444
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Fax | 209-852-2287
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Provider Business Mailing Address
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Address Line | 1524 MCHENRY AVE STE 420
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City | MODESTO
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State | CA
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Zip | 95350-4567
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Country | US
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Telephone | 209-577-4444
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Fax | 813-916-2944
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A194696
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License Number State | CA
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