MEDICARE: THINH V NGUYEN, MD INC

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	207R00000X	Internal Medicine Physician	C41885	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	:	1558394163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THINH V NGUYEN, MD INC

Provider Business Mailing Address
First Line	:	2470 ALVIN AVE
Second Line	:	SUITE 70
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1664
Country	:	US
Telephone Number	:	408-223-0505
Fax Number	:	408-223-9791

Provider Business Practice Location Address
First Line	:	2470 ALVIN AVE
Second Line	:	SUITE 70
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1664
Country	:	US
Telephone Number	:	408-223-0505
Fax Number	:	408-223-9791

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	THINH VAN NGUYEN
Credential	:	MD
Telephone Number	:	408-223-0505

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	01/22/2015

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