Provider Demographics
NPI:1538375100
Name:NGUYEN, VINCENT V (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:V
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 1:649 SOUTH LINCOLN ST
Mailing Address - Street 2:24
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-5353
Mailing Address - Country:US
Mailing Address - Phone:619-590-2896
Mailing Address - Fax:
Practice Address - Street 1:5871 UNIVERSITY AVE
Practice Address - Street 2:334
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-6200
Practice Address - Country:US
Practice Address - Phone:619-582-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73567208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice