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General NPI Number Information
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NPI Number | 1922207463
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Entity Type | Organization
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Legal Business Name | TQ PEDIATRICS, INC.
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Dates
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Enumeration Date | 07/14/2007
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 10900 WARNER AVE SUITE 118
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-3846
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Country | US
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Telephone | 714-968-7938
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Fax | 714-968-7990
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Provider Business Mailing Address
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Address Line | PO BOX 11704
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City | WESTMINSTER
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State | CA
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Zip | 92685-1704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | THANH QUOC NGUYEN
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Credential |
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Telephone | 714-968-7938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A92305
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License Number State | CA
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