MEDICARE: DUC MINH NGUYEN

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	172A00000X	Driver

General Provider Information

NPI Number	:	1194994590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUC MINH NGUYEN

Provider Business Mailing Address
First Line	:	6911 JACKSON DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-3004
Country	:	US
Telephone Number	:	858-348-7896
Fax Number	:

Provider Business Practice Location Address
First Line	:	6911 JACKSON DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-3004
Country	:	US
Telephone Number	:	858-348-7896
Fax Number	:

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

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	02/29/2008

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Directions to “ DUC MINH NGUYEN ” Practice Location

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