MEDICARE: ANH TAI 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
1	207Q00000X	Family Medicine Physician	176263-1205	UT

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	:	1841497559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANH TAI NGUYEN,MD

Provider Business Mailing Address
First Line	:	1819 W 3500 S STE 1C
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-3457
Country	:	US
Telephone Number	:	801-975-9707
Fax Number	:

Provider Business Practice Location Address
First Line	:	1819 W 3500 S STE 1C
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-3457
Country	:	US
Telephone Number	:	801-975-9707
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANH TAI NGUYEN
Credential	:	M.D.
Telephone Number	:	801-975-9707

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	08/22/2020

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