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General NPI Number Information
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NPI Number | 1902989064
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Entity Type | Individual
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Provider Name | LI NGUYEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 15751 BROOKHURST ST STE 118
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City | WESTMINSTER
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State | CA
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Zip | 92683-7567
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Country | US
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Telephone | 714-775-8728
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Fax | 714-775-2194
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Provider Business Mailing Address
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Address Line | 15751 BROOKHURST ST STE 105
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City | WESTMINSTER
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State | CA
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Zip | 92683-7567
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Country | US
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Telephone | 714-775-6256
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Fax | 714-775-6256
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | G63837
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License Number State | CA
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