Provider Demographics
NPI:1902145592
Name:NGUYEN, THANH-TAM NGOC (DO)
Entity type:Individual
Prefix:DR
First Name:THANH-TAM
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16360 MONTEREY RD STE 270
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5496
Mailing Address - Country:US
Mailing Address - Phone:408-763-5060
Mailing Address - Fax:408-763-4182
Practice Address - Street 1:16360 MONTEREY RD STE 270
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5496
Practice Address - Country:US
Practice Address - Phone:408-763-5060
Practice Address - Fax:408-763-4182
Is Sole Proprietor?:No
Enumeration Date:2013-02-03
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine