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General NPI Number Information
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NPI Number | 1811733439
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Entity Type | Individual
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Provider Name | TRONG BAO NGUYEN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/03/2024
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 400 W CIVIC CENTER DR
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City | SANTA ANA
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State | CA
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Zip | 92701-4521
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Country | US
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Telephone | 714-834-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 5102 W 7TH ST
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City | SANTA ANA
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State | CA
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Zip | 92703-2529
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Country | US
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Telephone | 714-467-7629
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95041661
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 95305035
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License Number State | CA
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