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NPI Code Detail

MEDICARE: RANDALL L NGUYEN MD

MEDICARE: RANDALL L NGUYEN 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
1207W00000XOphthalmology PhysicianA55189CA

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 : 1750382008
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDALL L NGUYEN MD
Provider Business Mailing Address
First Line : 4300 LONG BEACH BLVD
Second Line : SUITE 300
City : LONG BEACH
State : CA
Zip : 90807-2011
Country : US
Telephone Number : 562-984-7024
Fax Number : 562-428-7394
Provider Business Practice Location Address
First Line : 4300 LONG BEACH BLVD
Second Line : SUITE 300
City : LONG BEACH
State : CA
Zip : 90807-2011
Country : US
Telephone Number : 562-984-7024
Fax Number : 562-428-7394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 07/08/2007

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Directions to “ RANDALL L NGUYEN MD” Practice Location

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