MEDICARE: ELENA Y NGUYEN MD

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	207W00000X	Ophthalmology Physician	A173649	CA

General Provider Information

NPI Number	:	1235592387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA Y NGUYEN MD

Provider Business Mailing Address
First Line	:	1241 E HILLSDALE BLVD STE 220
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1296
Country	:	US
Telephone Number	:	650-288-1633
Fax Number	:	650-288-6933

Provider Business Practice Location Address
First Line	:	1241 E HILLSDALE BLVD STE 220
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1296
Country	:	US
Telephone Number	:	650-288-1633
Fax Number	:	650-288-6933

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

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	01/09/2023

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