MEDICARE: DR. DUC CHI 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
1	207P00000X	Emergency Medicine Physician	A87268	CA

General Provider Information

NPI Number	:	1720032022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUC CHI NGUYEN M.D.

Provider Business Mailing Address
First Line	:	314 S DEMING ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-1028
Country	:	US
Telephone Number	:	310-963-4382
Fax Number	:

Provider Business Practice Location Address
First Line	:	25825 VERMONT AVE
Second Line	:	MEDICAL STAFF OFFICE
City	:	HARBOR CITY
State	:	CA
Zip	:	90710-3518
Country	:	US
Telephone Number	:	310-325-5111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	12/01/2021

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