Provider Demographics
NPI:1962289991
Name:NGUYEN, TONY TUAN (NP)
Entity type:Individual
Prefix:MR
First Name:TONY
Middle Name:TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:TUAN
Other - Middle Name:NGOC
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:706 LA VERGN WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2632
Mailing Address - Country:US
Mailing Address - Phone:714-582-9721
Mailing Address - Fax:
Practice Address - Street 1:706 LA VERGN WAY
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2632
Practice Address - Country:US
Practice Address - Phone:714-582-9721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95174384163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical