MEDICARE: LOUIE HOANG NGUYEN MD, A PROFESSIONAL MEDICAL CORPORATION

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	207L00000X	Anesthesiology Physician	G72589	CA

General Provider Information

NPI Number	:	1619171477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUIE HOANG NGUYEN MD, A PROFESSIONAL MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 4148
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90510-4148
Country	:	US
Telephone Number	:	310-792-3914
Fax Number	:	310-792-3621

Provider Business Practice Location Address
First Line	:	2880 ATLANTIC AVE STE 180
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1736
Country	:	US
Telephone Number	:	562-426-2606
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LOUIE HOANG NGUYEN
Credential	:	M.D.
Telephone Number	:	310-792-3914

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	08/22/2020

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