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General NPI Number Information
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NPI Number | 1154569986
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Entity Type | Organization
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Legal Business Name | TUAN NGUYEN, M.D., INC
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 4141 FAIRMOUNT AVE SUITE #201
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City | SAN DIEGO
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State | CA
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Zip | 92105-1609
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Country | US
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Telephone | 619-563-4040
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Fax | 619-563-1204
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Provider Business Mailing Address
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Address Line | PO BOX 420988
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City | SAN DIEGO
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State | CA
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Zip | 92142-0988
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Country | US
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Telephone | 619-563-4040
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Fax | 619-563-1204
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TUAN NGUYEN
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Credential | MD
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Telephone | 619-563-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G68761
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License Number State | CA
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