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NPI Code Detail

MEDICARE: MR. RAYMOND TRAN NGUYEN NP

MEDICARE: MR. RAYMOND TRAN NGUYEN NP
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
1363LG0600XGerontology Nurse Practitioner95013061CA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner95013061CA

General Provider Information

NPI Number : 1871136929
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAYMOND TRAN NGUYEN NP
Provider Business Mailing Address
First Line : PO BOX 512185
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051-0185
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2029 CENTURY PARK E STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90067-2905
Country : US
Telephone Number : 626-256-4673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2019
Last Update Date : 01/04/2024

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