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General NPI Number Information
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NPI Number | 1427206093
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Entity Type | Individual
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Provider Name | THERESA THU THAO NGUYEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 905 MAPLE ST
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City | REDWOOD CITY
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State | CA
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Zip | 94063-2057
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Country | US
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Telephone | 650-299-2066
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Fax |
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Provider Business Mailing Address
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Address Line | 2667 21ST AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-3016
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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 |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 125051600
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 256836-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | H0073311
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0102202992
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | DO034365
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License Number State | DC
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