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General NPI Number Information
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NPI Number | 1528745148
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Entity Type | Organization
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Legal Business Name | JULLIAN NGUYEN MD SPORTS & FAMILY MEDICINE
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 930 SUNNYSLOPE RD STE E1
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City | HOLLISTER
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State | CA
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Zip | 95023-5638
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Country | US
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Telephone | 408-726-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 LILAC ST
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City | HOLLISTER
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State | CA
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Zip | 95023-6552
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Country | US
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Telephone | 408-726-4501
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JULLIAN PHAM NGUYEN
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Credential | MD
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Telephone | 408-726-4501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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