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NPI Code Detail

MEDICARE: QUYNAM P NGUYEN M.D.

MEDICARE: QUYNAM P 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
1207R00000XInternal Medicine PhysicianG56407CA

General Provider Information

NPI Number : 1255452454
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUYNAM P NGUYEN M.D.
Provider Business Mailing Address
First Line : 1024 E PACIFIC COAST HWY
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-5017
Country : US
Telephone Number : 562-218-0131
Fax Number : 562-218-1112
Provider Business Practice Location Address
First Line : 3712 WHITTIER BLVD
Second Line : 1024 E PACIFIC COAST HWY
City : LOS ANGELES
State : CA
Zip : 90023-1733
Country : US
Telephone Number : 323-268-8347
Fax Number : 323-268-8368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 12/05/2011

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