MEDICARE: DR. DINH-CHI NGUYEN DPM

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	213E00000X	Podiatrist	E4149	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000E41490	OTHER		BLUE SHIELD

General Provider Information

NPI Number	:	1346232576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DINH-CHI NGUYEN DPM

Provider Business Mailing Address
First Line	:	9300 STOCKDALE HWY
Second Line	:	SUITE 400
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-3611
Country	:	US
Telephone Number	:	661-663-8483
Fax Number	:	661-663-3095

Provider Business Practice Location Address
First Line	:	9300 STOCKDALE HWY
Second Line	:	SUITE 400
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-3611
Country	:	US
Telephone Number	:	661-663-8483
Fax Number	:	661-663-3095

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	09/24/2012

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