MEDICARE: DR. AI QUOC NGUYEN HELLER D.P.M

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	1205	NV

General Provider Information

NPI Number	:	1518213578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AI QUOC NGUYEN HELLER D.P.M

Provider Business Mailing Address
First Line	:	PO BOX 50605
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89016-0605
Country	:	US
Telephone Number	:	702-623-9585
Fax Number	:	702-586-7306

Provider Business Practice Location Address
First Line	:	8420 W WARM SPRINGS RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3624
Country	:	US
Telephone Number	:	702-740-5327
Fax Number	:	702-740-5328

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

Provider Enumeration Date	:	07/27/2012
Last Update Date	:	05/01/2017

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