MEDICARE: KYLE VIET 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1841622651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE VIET NGUYEN

Provider Business Mailing Address
First Line	:	8251 WESTMINSTER BLVD STE 110
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-3370
Country	:	US
Telephone Number	:	714-620-7053
Fax Number	:	714-620-7051

Provider Business Practice Location Address
First Line	:	8251 WESTMINSTER BLVD STE 110
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-3370
Country	:	US
Telephone Number	:	714-620-7053
Fax Number	:	714-620-7051

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

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	12/12/2013

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Directions to “ KYLE VIET NGUYEN ” Practice Location

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