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General NPI Number Information
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NPI Number | 1154657757
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Entity Type | Organization
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Legal Business Name | GIAO T NGUYEN
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 975 SAINT JOHN PL STE B
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City | HEMET
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State | CA
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Zip | 92543-4428
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Country | US
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Telephone | 951-658-2256
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Fax | 951-658-8956
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Provider Business Mailing Address
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Address Line | 975 SAINT JOHN PL STE B
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City | HEMET
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State | CA
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Zip | 92543-4428
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Country | US
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Telephone | 951-658-2256
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Fax | 951-658-8956
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Authorized Official
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Title or Position | OWNER
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Name | DR. GIAO NGUYEN
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Credential | D.P.M.
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Telephone | 951-658-2256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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