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General NPI Number Information
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NPI Number | 1831614353
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Entity Type | Individual
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Provider Name | KHANH NGOC CONG HUYEN TON NU PA-C, MPH
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Gender | Female
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 7382 NATAL DR
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City | WESTMINSTER
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State | CA
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Zip | 92683-2245
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Country | US
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Telephone | 17147933627
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Fax |
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Provider Business Mailing Address
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Address Line | 7382 NATAL DR
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City | WESTMINSTER
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State | CA
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Zip | 92683-2245
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Country | US
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Telephone | 17147933627
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 54711
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License Number State | CA
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