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General NPI Number Information
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NPI Number | 1841497559
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Entity Type | Organization
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Legal Business Name | ANH TAI NGUYEN,MD
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1819 W 3500 S STE 1C
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City | WEST VALLEY CITY
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State | UT
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Zip | 84119-3457
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Country | US
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Telephone | 801-975-9707
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Fax |
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Provider Business Mailing Address
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Address Line | 1819 W 3500 S STE 1C
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City | WEST VALLEY CITY
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State | UT
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Zip | 84119-3457
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Country | US
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Telephone | 801-975-9707
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANH TAI NGUYEN
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Credential | M.D.
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Telephone | 801-975-9707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 176263-1205
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License Number State | UT
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