Provider Demographics
NPI:1538393608
Name:NGUYEN, ANTHONY SCOTT
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:SCOTT
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1330 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1513
Mailing Address - Country:US
Mailing Address - Phone:415-513-7073
Mailing Address - Fax:
Practice Address - Street 1:100 BUSH ST STE 420
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3907
Practice Address - Country:US
Practice Address - Phone:415-956-2884
Practice Address - Fax:415-956-2662
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4979213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery