MEDICARE: BAO-THU THI 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	207W00000X	Ophthalmology Physician	A62609	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	:	1538137666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAO-THU THI NGUYEN M.D.

Provider Business Mailing Address
First Line	:	4300 LONG BEACH BLVD STE 400
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2008
Country	:	US
Telephone Number	:	562-591-7700
Fax Number	:	562-591-1311

Provider Business Practice Location Address
First Line	:	4300 LONG BEACH BLVD STE 400
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2008
Country	:	US
Telephone Number	:	562-591-7700
Fax Number	:	562-591-7700

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	02/27/2024

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