Provider Demographics
NPI:1528248770
Name:NGUYEN, NHAN X (MD)
Entity type:Individual
Prefix:
First Name:NHAN
Middle Name:X
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10298 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4830
Mailing Address - Country:US
Mailing Address - Phone:714-537-8269
Mailing Address - Fax:714-537-8065
Practice Address - Street 1:10298 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4830
Practice Address - Country:US
Practice Address - Phone:714-537-8269
Practice Address - Fax:714-537-8065
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3466138Medicaid
CA3466138Medicaid
CAWA50424AMedicare PIN