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General NPI Number Information
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NPI Number | 1548272917
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Entity Type | Organization
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Legal Business Name | DAT MANH NGUYEN M D A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 14536 BROOKHURST ST SUITE #102
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City | WESTMINSTER
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State | CA
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Zip | 92683-5787
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Country | US
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Telephone | 714-531-2548
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Fax | 714-531-2450
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Provider Business Mailing Address
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Address Line | 14536 BROOKHURST ST SUITE #102
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City | WESTMINSTER
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State | CA
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Zip | 92683-5787
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Country | US
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Telephone | 714-531-2548
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Fax | 714-531-2450
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAT MANH NGUYEN
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Credential | M.D.
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Telephone | 714-531-2548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | A36056
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License Number State | CA
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