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General NPI Number Information
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NPI Number | 1225830227
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Entity Type | Individual
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Provider Name | ANGELINA NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 15420 CRENSHAW BLVD
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City | GARDENA
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State | CA
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Zip | 90249-4524
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Country | US
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Telephone | 310-324-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 11601 ROSEMARY AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-1864
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Country | US
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Telephone | 714-768-1018
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 65898
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License Number State | CA
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