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General NPI Number Information
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NPI Number | 1619206489
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Entity Type | Individual
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Provider Name | VAN-MINH NGUYEN P.A-C
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Gender | Male
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 2020 J ST
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City | SACRAMENTO
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State | CA
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Zip | 95811-3120
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Country | US
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Telephone | 916-341-0576
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 J ST
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City | SACRAMENTO
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State | CA
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Zip | 95811-3120
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Country | US
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Telephone | 817-478-6041
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Fax | 817-478-6041
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06491
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 56720
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License Number State | CA
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