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General NPI Number Information
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NPI Number | 1215091434
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Entity Type | Organization
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Legal Business Name | TIEP KIM NGUYEN MD INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 02/26/2011
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Provider Practice Location Address
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Address Line | 12650 SHERMAN WAY SUITE 3
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-5232
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Country | US
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Telephone | 818-764-5775
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Fax | 818-764-6273
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Provider Business Mailing Address
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Address Line | 12650 SHERMAN WAY SUITE3
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605
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Country | US
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Telephone | 818-764-5775
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Fax | 818-764-6273
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TIEP KIM NGUYEN
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Credential | M.D
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Telephone | 818-764-5775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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