Provider Demographics
NPI:1124258116
Name:NGUYEN, THUY ROSE (DO)
Entity type:Individual
Prefix:
First Name:THUY ROSE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W RANCH VIEW DR
Mailing Address - Street 2:SUITE 2005
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 W RANCH VIEW DR
Practice Address - Street 2:SUITE 2005
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5396
Practice Address - Country:US
Practice Address - Phone:916-295-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine