MEDICARE: DR. SARAH NGHIEM D.O.

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	207Q00000X	Family Medicine Physician	20A8845	CA

General Provider Information

NPI Number	:	1720270945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH NGHIEM D.O.

Provider Business Mailing Address
First Line	:	10141 WESTMINSTER AVE
Second Line	:	SUITE E
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4788
Country	:	US
Telephone Number	:	714-467-4321
Fax Number	:	714-467-4311

Provider Business Practice Location Address
First Line	:	10141 WESTMINSTER AVE
Second Line	:	SUITE E
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4788
Country	:	US
Telephone Number	:	714-467-4321
Fax Number	:	714-467-4311

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

Provider Enumeration Date	:	08/11/2007
Last Update Date	:	09/22/2007

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