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General NPI Number Information
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NPI Number | 1093856270
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Entity Type | Organization
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Legal Business Name | HAI HOANG NGUYEN MD INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 210 N JACKSON AVE SUITE 20
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City | SAN JOSE
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State | CA
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Zip | 95116-1621
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Country | US
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Telephone | 408-251-6127
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Fax | 408-251-8990
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Provider Business Mailing Address
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Address Line | 210 N JACKSON AVE SUITE 20
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City | SAN JOSE
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State | CA
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Zip | 95116-1621
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Country | US
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Telephone | 408-251-6127
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Fax | 408-251-8990
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Authorized Official
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Title or Position | OWNER
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Name | HAI HOANG NGUYEN
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Credential | M.D.
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Telephone | 408-251-6127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A344680
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License Number State | CA
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