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General NPI Number Information
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NPI Number | 1124280201
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Entity Type | Organization
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Legal Business Name | PHUC DANG NGUYEN MD INC
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 7901 WESTMINSTER BLVD
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City | WESTMINSTER
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State | CA
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Zip | 92683-4001
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Country | US
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Telephone | 714-898-9368
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 WESTMINSTER BLVD
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City | WESTMINSTER
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State | CA
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Zip | 92683-4001
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Country | US
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Telephone | 714-898-9368
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHUC DANG NGUYEN
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Credential | M.D
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Telephone | 714-898-9368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | A32505
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License Number State | CA
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