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NPI Code Detail

MEDICARE: MICHAEL DINH NGUYEN MS, BCBA

MEDICARE:   MICHAEL DINH NGUYEN  MS, BCBA
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
1103K00000XBehavior Analyst1-17-26675CO

General Provider Information

NPI Number : 1245755248
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL DINH NGUYEN MS, BCBA
Provider Business Mailing Address
First Line : 3257 E GUASTI RD STE 210
Second Line :
City : ONTARIO
State : CA
Zip : 91761-1235
Country : US
Telephone Number : 626-406-0687
Fax Number :
Provider Business Practice Location Address
First Line : 3257 E GUASTI RD STE 210
Second Line :
City : ONTARIO
State : CA
Zip : 91761-1235
Country : US
Telephone Number : 626-406-0687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2017
Last Update Date : 04/19/2021

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