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General NPI Number Information
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NPI Number | 1811764061
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Entity Type | Organization
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Legal Business Name | TIEN QUOC NGUYEN DPM, INC.
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 14360 BROOKHURST ST
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4608
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Country | US
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Telephone | 714-531-9682
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Fax |
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Provider Business Mailing Address
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Address Line | 1849 W REGATTA RD
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City | ANAHEIM
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State | CA
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Zip | 92804-5581
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Country | US
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Telephone | 714-452-4519
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. TIEN QUOC NGUYEN
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Credential | DPM
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Telephone | 714-531-9682
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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 |
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License Number State |
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