MEDICARE: VINH NGOC NGUYEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	45868	AZ
2	2085R0202X	Diagnostic Radiology Physician	A120788	CA
3	2085R0202X	Diagnostic Radiology Physician	ME113630	FL
4	2085R0202X	Diagnostic Radiology Physician	7675702-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003077256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINH NGOC NGUYEN M.D.

Provider Business Mailing Address
First Line	:	16061 MULLIEN CIRCLE
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-1525
Country	:	US
Telephone Number	:	714-642-6548
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 W COAST HWY STE B
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4007
Country	:	US
Telephone Number	:	888-762-4127
Fax Number	:	714-571-5055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	08/14/2012

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Directions to “ VINH NGOC NGUYEN M.D.” Practice Location

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