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General NPI Number Information
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NPI Number | 1750578126
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Entity Type | Organization
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Legal Business Name | PHUOC HUU NGUYEN, MD, INC.
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 310 N CITRUS AVE SUITE A
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City | AZUSA
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State | CA
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Zip | 91702-3957
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Country | US
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Telephone | 626-969-8688
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Fax | 626-812-9473
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Provider Business Mailing Address
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Address Line | 18760 AMAR RD PMB # 187
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City | WALNUT
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State | CA
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Zip | 91789-4169
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Country | US
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Telephone | 626-969-8688
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Fax | 626-812-9473
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHUOC HUU NGUYEN
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Credential | MD
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Telephone | 626-969-8688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A64287
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License Number State | CA
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