Provider Demographics
NPI:1093100232
Name:NGUYEN, DUY DUC (DO)
Entity type:Individual
Prefix:
First Name:DUY
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17982 SKY PARK CIR STE J
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6482
Mailing Address - Country:US
Mailing Address - Phone:949-809-5700
Mailing Address - Fax:949-809-5789
Practice Address - Street 1:17982 SKY PARK CIR STE J
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6482
Practice Address - Country:US
Practice Address - Phone:949-809-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-04
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A15314207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine