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General NPI Number Information
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NPI Number | 1619775087
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Entity Type | Individual
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Provider Name | TUANANH NGUYEN VU NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1100 SAN BERNARDINO RD STE 1100
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City | UPLAND
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State | CA
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Zip | 91786-4952
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Country | US
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Telephone | 626-218-7593
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Fax | 909-532-8015
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Provider Business Mailing Address
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Address Line | 5750 CHANDLER CT
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2445
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Country | US
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Telephone | 909-241-9639
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Fax | 909-532-8015
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95033012
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License Number State | CA
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