MEDICARE: PAUL NGUYEN MD LTD

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	2084P0800X	Psychiatry Physician	12178	NV

General Provider Information

NPI Number	:	1124406129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL NGUYEN MD LTD

Provider Business Mailing Address
First Line	:	PO BOX 36830
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-6830
Country	:	US
Telephone Number	:	702-487-7055
Fax Number	:

Provider Business Practice Location Address
First Line	:	2031 MCDANIEL ST STE 230
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89030-6309
Country	:	US
Telephone Number	:	702-405-9080
Fax Number	:	702-405-9240

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL NGUYEN
Credential	:	MD
Telephone Number	:	702-685-0674

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	11/27/2017

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