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General NPI Number Information
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NPI Number | 1396960563
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Entity Type | Organization
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Legal Business Name | GARDEN GROVE WOMEN'S HEALTH SPECIALISTS, INC.
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Dates
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Enumeration Date | 04/14/2007
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 12555 GARDEN GROVE BLVD STE 301
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1903
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Country | US
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Telephone | 714-741-0501
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Fax | 714-741-0095
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Provider Business Mailing Address
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Address Line | 12555 GARDEN GROVE BLVD STE 301
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1903
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Country | US
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Telephone | 714-741-0501
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Fax | 714-741-0095
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHU NGUYEN
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Credential | D.O.
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Telephone | 714-741-0501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 20A7161
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License Number State | CA
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