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NPI Code Detail

MEDICARE: DR. LISA VO NGUYEN DDS

MEDICARE: DR. LISA VO NGUYEN DDS
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
1122300000XDentist53023CA

General Provider Information

NPI Number : 1508912874
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA VO NGUYEN DDS
Provider Business Mailing Address
First Line : 9001 JENNRICH AVE
Second Line :
City : WESTMINSTER
State : CA
Zip : 92683-5104
Country : US
Telephone Number :
Fax Number : 323-249-7565
Provider Business Practice Location Address
First Line : 2144 S BRISTOL ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-5123
Country : US
Telephone Number : 714-619-6280
Fax Number : 323-249-7565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 12/17/2008

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