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General NPI Number Information
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NPI Number | 1821513870
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Entity Type | Organization
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Legal Business Name | DR. ROGER NGUYEN, A CORPORATION
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Dates
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Enumeration Date | 08/10/2017
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Last Update Date | 08/10/2017
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Provider Practice Location Address
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Address Line | 9746 WESTMINSTER AVE STE A
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City | GARDEN GROVE
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State | CA
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Zip | 92844-2984
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Country | US
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Telephone | 714-638-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 9746 WESTMINSTER AVE STE A
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City | GARDEN GROVE
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State | CA
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Zip | 92844-2984
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROGER NGUYEN
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Credential | MD
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Telephone | 714-638-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | A68125
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License Number State | CA
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