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General NPI Number Information
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NPI Number | 1740563055
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Entity Type | Organization
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Legal Business Name | KELVIN H NGUYEN FOOT & ANKLE CORPORATION
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 210 N GARFIELD AVE SUITE 305
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City | MONTEREY PARK
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State | CA
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Zip | 91754-1746
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Country | US
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Telephone | 626-310-4507
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Fax | 626-532-8733
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Provider Business Mailing Address
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Address Line | 10091 NORTHAMPTON AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-7535
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Country | US
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Telephone | 626-310-4507
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Fax | 626-532-8733
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Authorized Official
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Title or Position | CEO
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Name | DR. KELVIN TANG NGUYEN
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Credential | DPM
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Telephone | 626-310-4507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4912
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License Number State | CA
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