MEDICARE: DR. THIEN-TRANG JOANNA NGUYEN M.D.

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	2086S0122X	Plastic and Reconstructive Surgery Physician	A124152	CA

General Provider Information

NPI Number	:	1871843243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THIEN-TRANG JOANNA NGUYEN M.D.

Provider Business Mailing Address
First Line	:	9201 W SUNSET BLVD STE 718
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-3708
Country	:	US
Telephone Number	:	310-737-8592
Fax Number	:

Provider Business Practice Location Address
First Line	:	9201 W SUNSET BLVD STE 718
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-3708
Country	:	US
Telephone Number	:	310-737-8592
Fax Number	:

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

Provider Enumeration Date	:	09/13/2012
Last Update Date	:	07/14/2019

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