Provider Demographics
NPI:1386080554
Name:HAI DONG NGUYEN, M.D., CORP.
Entity type:Organization
Organization Name:HAI DONG NGUYEN, M.D., CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HAI
Authorized Official - Middle Name:DONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-675-3937
Mailing Address - Street 1:2907 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-1195
Mailing Address - Country:US
Mailing Address - Phone:714-675-3937
Mailing Address - Fax:714-820-4980
Practice Address - Street 1:10402 WESTMINSTER AVE
Practice Address - Street 2:SUIT 100B
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4862
Practice Address - Country:US
Practice Address - Phone:714-675-3937
Practice Address - Fax:714-820-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114137207R00000X, 208D00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty