MEDICARE: HA SON 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	207V00000X	Obstetrics & Gynecology Physician	G67118	CA

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	:	1447275631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HA SON NGUYEN M.D.

Provider Business Mailing Address
First Line	:	1951 PACIFIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-5321
Country	:	US
Telephone Number	:	562-218-8778
Fax Number	:	562-218-1916

Provider Business Practice Location Address
First Line	:	1951 PACIFIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-5321
Country	:	US
Telephone Number	:	562-218-8778
Fax Number	:	562-218-1916

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	09/22/2021

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Directions to “ HA SON NGUYEN M.D.” Practice Location

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