MEDICARE: ANH PHUONG 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1801752506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANH PHUONG NGUYEN

Provider Business Mailing Address
First Line	:	1068 HICKORYNUT CT
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1723
Country	:	US
Telephone Number	:	669-254-6350
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 FAIRMONT DR
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94578-1001
Country	:	US
Telephone Number	:	510-895-5502
Fax Number	:

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

Provider Enumeration Date	:	12/27/2025
Last Update Date	:	12/27/2025

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Directions to “ ANH PHUONG NGUYEN ” Practice Location

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