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General NPI Number Information
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NPI Number | 1841567351
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Entity Type | Organization
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Legal Business Name | QUAN H. NGUYEN M D A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 10175 SLATER AVE STE 100
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4702
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Country | US
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Telephone | 714-979-9911
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Fax | 714-979-9912
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Provider Business Mailing Address
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Address Line | 10175 SLATER AVE STE 100
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4702
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Country | US
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Telephone | 714-979-9911
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Fax | 714-979-9912
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Authorized Official
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Title or Position | MGR
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Name | PAULINE TANG
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Credential |
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Telephone | 714-979-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G071956
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License Number State | CA
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