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General NPI Number Information
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NPI Number | 1821238064
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Entity Type | Organization
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Legal Business Name | DAVID TRUNG D. NGUYEN, M.D., INC.
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Dates
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Enumeration Date | 02/28/2009
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 1869 N WATERMAN AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4830
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Country | US
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Telephone | 909-883-8686
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Fax | 909-881-6537
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Provider Business Mailing Address
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Address Line | 1869 N WATERMAN AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4830
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Country | US
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Telephone | 909-883-8686
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Fax | 909-881-6537
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID-TRUNG D NGUYEN
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Credential |
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Telephone | 909-883-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A82169
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License Number State | CA
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