MEDICARE: CAROLINE 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	208000000X	Pediatrics Physician	15854	NV

General Provider Information

NPI Number	:	1104113471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE NGUYEN M.D.

Provider Business Mailing Address
First Line	:	3201 S MARYLAND PKWY STE 608
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2428
Country	:	US
Telephone Number	:	702-457-5437
Fax Number	:	702-464-5801

Provider Business Practice Location Address
First Line	:	3201 S MARYLAND PKWY
Second Line	:	STE 608
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2441
Country	:	US
Telephone Number	:	702-457-5437
Fax Number	:

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

Provider Enumeration Date	:	07/06/2011
Last Update Date	:	12/08/2025

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