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General NPI Number Information
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NPI Number | 1235091679
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Entity Type | Organization
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Legal Business Name | VAN NGUYEN LLC PAC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 10327 DALLINGTON ST
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City | LAS VEGAS
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State | NV
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Zip | 89141-9032
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Country | US
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Telephone | 714-360-9165
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Fax |
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Provider Business Mailing Address
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Address Line | 10327 DALLINGTON ST
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City | LAS VEGAS
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State | NV
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Zip | 89141-9032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VAN NGUYEN
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Credential | PA-C
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Telephone | 714-360-9165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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