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NPI Code Detail

MEDICARE: HANH THI NGUYEN-CLARK MD

MEDICARE: HANH THI NGUYEN-CLARK 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
1207L00000XAnesthesiology PhysicianA62739CA

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 : 1649222308
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANH THI NGUYEN-CLARK MD
Provider Business Mailing Address
First Line : PO BOX 3129
Second Line :
City : TORRANCE
State : CA
Zip : 90510-3129
Country : US
Telephone Number : 310-792-3914
Fax Number : 855-898-4055
Provider Business Practice Location Address
First Line : 3630 E IMPERIAL HWY
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-2609
Country : US
Telephone Number : 310-900-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 12/11/2025

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