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General NPI Number Information
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NPI Number | 1891134243
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Entity Type | Individual
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Provider Name | MAIKA TAN NGUYEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 4759 US HIGHWAY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4945
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Country | US
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Telephone | 727-841-8772
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Fax | 727-841-5897
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Provider Business Mailing Address
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Address Line | 460 N ELM ST
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City | ESCONDIDO
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State | CA
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Zip | 92025-3002
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Country | US
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Telephone | 833-867-4642
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS17168
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6301
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License Number State | OK
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