MEDICARE: CHI M 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	146D00000X	Personal Emergency Response Attendant	G77715	CA
2	207P00000X	Emergency Medicine Physician	G77715	CA

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	:	1972569903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHI M NGUYEN M.D.

Provider Business Mailing Address
First Line	:	6512 OAKHURST CIR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6636
Country	:	US
Telephone Number	:	714-969-4303
Fax Number	:

Provider Business Practice Location Address
First Line	:	17100 EUCLID AVENUE
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708
Country	:	US
Telephone Number	:	714-966-8105
Fax Number	:

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	05/19/2008

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