Provider Demographics
NPI:1962520478
Name:NGUYEN, TAM HOANG (DO)
Entity type:Individual
Prefix:DR
First Name:TAM
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4945 PALEMETTO DUNES CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-2131
Mailing Address - Country:US
Mailing Address - Phone:408-258-5083
Mailing Address - Fax:408-258-4347
Practice Address - Street 1:200 JOSE FIGUERES AVE STE 180
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1586
Practice Address - Country:US
Practice Address - Phone:408-258-5083
Practice Address - Fax:408-258-4347
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9636208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A9636OtherMEDICAL LICENSE