MEDICARE: DR. TRI MINH 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	174400000X	Specialist	30646	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255379442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRI MINH NGUYEN M.D.

Provider Business Mailing Address
First Line	:	20414 N 27TH AVE
Second Line	:	SUITE 300
City	:	PHOENIX
State	:	AZ
Zip	:	85027-3250
Country	:	US
Telephone Number	:	623-879-6000
Fax Number	:	623-516-2000

Provider Business Practice Location Address
First Line	:	20414 N 27TH AVE
Second Line	:	SUITE 300
City	:	PHOENIX
State	:	AZ
Zip	:	85027-3250
Country	:	US
Telephone Number	:	623-879-6000
Fax Number	:	623-516-2000

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	10/25/2023

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