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NPI Code Detail

MEDICARE: DIEMCHI NGUYENPHUC MD

MEDICARE: DIEMCHI NGUYENPHUC MD
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
1207V00000XObstetrics & Gynecology PhysicianG68620CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629104930
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIEMCHI NGUYENPHUC MD
Provider Business Mailing Address
First Line : 6572 POLO CIR
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92648-1542
Country : US
Telephone Number : 714-916-6453
Fax Number :
Provider Business Practice Location Address
First Line : 3501 S HARBOR BLVD
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-6919
Country : US
Telephone Number : 714-929-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 01/24/2017

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Directions to “ DIEMCHI NGUYENPHUC MD” Practice Location

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