Physician Compare National (NPI:1265590897)

HEALTHCARE PROVIDER: KHANG THAI NGUYEN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1265590897
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911086418
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080508000840
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NGUYEN
	Individual professional last name
Provider First Name	KHANG
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HAND SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	MAXILLOFACIAL SURGERY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HAND SURGERY, MAXILLOFACIAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	6610 FLANDERS DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	SAN DIEGO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	921213940
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y