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General NPI Number Information
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NPI Number | 1588056386
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Entity Type | Organization
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Legal Business Name | THUY TUONG NGUYEN MD MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 03/03/2015
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Provider Practice Location Address
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Address Line | 200 JOSE FIGUERES AVE STE 395
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City | SAN JOSE
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State | CA
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Zip | 95116-1500
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Country | US
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Telephone | 408-309-7454
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Fax |
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Provider Business Mailing Address
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Address Line | 991 MONTAGUE EXPY STE 203
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City | MILPITAS
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State | CA
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Zip | 95035-6809
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Country | US
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Telephone | 408-309-7454
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | THUY T NGUYEN
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Credential | M.D
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Telephone | 408-309-7454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A93782
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License Number State | CA
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