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General NPI Number Information
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NPI Number | 1538225156
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Entity Type | Organization
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Legal Business Name | LIEN HUYEN THI NGUYEN, MD., INC.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 73 W MARCH LN STE. C
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City | STOCKTON
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State | CA
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Zip | 95207-5726
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Country | US
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Telephone | 209-957-3901
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Fax | 209-957-2857
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Provider Business Mailing Address
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Address Line | 73 W MARCH LN STE. C
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City | STOCKTON
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State | CA
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Zip | 95207-5726
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Country | US
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Telephone | 209-957-3901
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Fax | 209-957-2857
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Authorized Official
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Title or Position | MANAGER
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Name | LEU VANG
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Credential |
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Telephone | 209-957-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 00A373770
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 00A373770
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License Number State | CA
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