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NPI Code Detail

MEDICARE: DR. TAN THE NGUYEN M.D.

MEDICARE:  DR. TAN THE 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
1207R00000XInternal Medicine PhysicianG67119CA

General Provider Information

NPI Number : 1609839299
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAN THE NGUYEN M.D.
Provider Business Mailing Address
First Line : 12865 MAIN ST STE 105
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92840-8205
Country : US
Telephone Number : 800-760-5520
Fax Number : 800-760-5520
Provider Business Practice Location Address
First Line : 12865 MAIN ST STE 105
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92840-8205
Country : US
Telephone Number : 800-768-1977
Fax Number : 800-768-1977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 07/22/2021

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Directions to “ DR. TAN THE NGUYEN M.D.” Practice Location

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