MEDICARE: DON NGUYEN

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	207R00000X	Internal Medicine Physician	MD60957806	WA
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	MD60957806	WA

Other Identifiers

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

General Provider Information

NPI Number	:	1720344617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DON NGUYEN

Provider Business Mailing Address
First Line	:	PO BOX 73488
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-0488
Country	:	US
Telephone Number	:	855-722-9700
Fax Number	:	253-559-6188

Provider Business Practice Location Address
First Line	:	10375 RICHMOND AVE STE 700
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-4165
Country	:	US
Telephone Number	:	855-722-9700
Fax Number	:	253-559-6188

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

Provider Enumeration Date	:	04/05/2012
Last Update Date	:	11/22/2022

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Directions to “ DON NGUYEN ” Practice Location

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