=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366570772
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINGS FOOT AND ANKLE CENTER, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 10/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 806 W 7TH ST
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-4926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-584-5196
-----------------------------------------------------
Fax | 559-584-9807
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 806 W 7TH ST
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-4926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-584-5196
-----------------------------------------------------
Fax | 559-584-9807
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. CHINH D NGUYEN
-----------------------------------------------------
Credential | D.P.M.
-----------------------------------------------------
Telephone | 559-584-5196
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------