MEDICARE: MRS. THERESA T. NGUYEN M.P.T.

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	225100000X	Physical Therapist	PT 24356	CA

General Provider Information

NPI Number	:	1922166800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THERESA T. NGUYEN M.P.T.

Provider Business Mailing Address
First Line	:	27141 HIDAWAY AVE
Second Line	:	SUITE 207
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-4131
Country	:	US
Telephone Number	:	661-424-9333
Fax Number	:	661-424-9463

Provider Business Practice Location Address
First Line	:	27141 HIDAWAY AVE
Second Line	:	SUITE 207
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-4131
Country	:	US
Telephone Number	:	661-424-9333
Fax Number	:	661-424-9463

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	06/17/2014

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