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General NPI Number Information
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NPI Number | 1255849865
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Entity Type | Individual
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Provider Name | HINH H NGUYEN PA
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Gender | Male
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 17150 EUCLID ST STE 200
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4092
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Country | US
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Telephone | 714-751-0997
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Fax | 714-751-5606
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Provider Business Mailing Address
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Address Line | 17150 EUCLID ST STE 200
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4092
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Country | US
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Telephone | 714-751-0997
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Fax | 714-751-5606
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 54929
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License Number State | CA
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