MEDICARE: DR. LONG H 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	207P00000X	Emergency Medicine Physician	A 98451	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	:	1538315981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LONG H NGUYEN M.D.

Provider Business Mailing Address
First Line	:	3043 RACETRACK VIEW DR
Second Line	:
City	:	DEL MAR
State	:	CA
Zip	:	92014-2462
Country	:	US
Telephone Number	:	858-869-5273
Fax Number	:

Provider Business Practice Location Address
First Line	:	3043 RACETRACK VIEW DR
Second Line	:
City	:	DEL MAR
State	:	CA
Zip	:	92014-2462
Country	:	US
Telephone Number	:	858-869-5273
Fax Number	:

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

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	09/29/2010

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