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General NPI Number Information
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NPI Number | 1679082531
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Entity Type | Individual
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Provider Name | TUYET VAN THI NGUYEN PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 39350 CIVIC CENTER DR
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City | FREMONT
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State | CA
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Zip | 94538-2343
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Country | US
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Telephone | 707-386-2680
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Fax |
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Provider Business Mailing Address
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Address Line | 811 ALMOND ST APT A
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City | SUISUN CITY
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State | CA
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Zip | 94585-6505
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Country | US
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Telephone | 17073862680
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Fax |
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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 | 20358
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License Number State | CA
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