MEDICARE: DAISIE NGUYEN

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	2355S0801X	Speech-Language Assistant	SPA3475	CA

General Provider Information

NPI Number	:	1356708382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAISIE NGUYEN

Provider Business Mailing Address
First Line	:	3620 LONG BEACH BLVD
Second Line	:	SUITE A1
City	:	LONG BEACH
State	:	CA
Zip	:	90807-4022
Country	:	US
Telephone Number	:	562-595-0912
Fax Number	:

Provider Business Practice Location Address
First Line	:	3620 LONG BEACH BLVD
Second Line	:	SUITE A1
City	:	LONG BEACH
State	:	CA
Zip	:	90807-4022
Country	:	US
Telephone Number	:	562-595-0912
Fax Number	:

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

Provider Enumeration Date	:	01/21/2016
Last Update Date	:	01/21/2016

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Directions to “ DAISIE NGUYEN ” Practice Location

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