Provider Demographics
NPI:1588779466
Name:NGUYEN, DUC HUU (DO)
Entity type:Individual
Prefix:
First Name:DUC
Middle Name:HUU
Last Name:NGUYEN
Suffix:
Gender:
Credentials:DO
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Mailing Address - Street 1:126 AVOCADO AVENUE, SUITE 106
Mailing Address - Street 2:126 AVOCADO AVE, SUITE 106
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-4200
Mailing Address - Country:US
Mailing Address - Phone:951-943-7212
Mailing Address - Fax:951-943-0139
Practice Address - Street 1:126 AVOCADO AVENUE, SUITE 106
Practice Address - Street 2:126 AVOCADO AVE, SUITE 106
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571
Practice Address - Country:US
Practice Address - Phone:951-943-7212
Practice Address - Fax:951-943-0139
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9168207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20A9168CMedicare PIN