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NPI Code Detail

MEDICARE: KHOA DANG NGUYEN

MEDICARE: KHOA DANG 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
1390200000XStudent in an Organized Health Care Education/Training Program
2175T00000XPeer SpecialistMPSS-QCRZBGCA
3373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1770166019
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHOA DANG NGUYEN
Provider Business Mailing Address
First Line : 1282 MARKET ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-4801
Country : US
Telephone Number : 510-899-3717
Fax Number :
Provider Business Practice Location Address
First Line : 555 STEVENSON ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94103-1606
Country : US
Telephone Number : 510-899-3717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2021
Last Update Date : 06/03/2026

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Directions to “ KHOA DANG NGUYEN ” Practice Location

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