MEDICARE: BAO CAO NGUYEN MD

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	2085R0202X	Diagnostic Radiology Physician	C164149	CA
2	2085R0202X	Diagnostic Radiology Physician	TM00078	TX
3	2085R0202X	Diagnostic Radiology Physician	MD.201298	LA
4	2085R0202X	Diagnostic Radiology Physician	25000	OK
5	2085R0202X	Diagnostic Radiology Physician	37910	CO

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982641916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAO CAO NGUYEN MD

Provider Business Mailing Address
First Line	:	PO BOX 974960
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75397-4960
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2365 QUIMBY RD STE 100
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1337
Country	:	US
Telephone Number	:	669-888-0001
Fax Number	:	669-888-0551

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/24/2025

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Directions to “ BAO CAO NGUYEN MD” Practice Location

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