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NPI Code Detail

MEDICARE: MS. TUTRAN NGUYEN DANG PA-C

MEDICARE: MS. TUTRAN NGUYEN DANG PA-C
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
1363AM0700XMedical Physician AssistantPA18778CA

General Provider Information

NPI Number : 1619152170
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TUTRAN NGUYEN DANG PA-C
Provider Business Mailing Address
First Line : 8510 BALBOA BLVD STE 150
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91325-5810
Country : US
Telephone Number : 818-637-2000
Fax Number : 818-654-3417
Provider Business Practice Location Address
First Line : 5995 TOPANGA CANYON BLVD
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3623
Country : US
Telephone Number : 818-888-7009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 12/22/2023

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