Provider Demographics
NPI:1962731281
Name:NGUYEN, CAROLYN V (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:V
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 W SUNSET BLVD
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5814
Mailing Address - Country:US
Mailing Address - Phone:323-783-6151
Mailing Address - Fax:
Practice Address - Street 1:4900 W SUNSET BLVD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5814
Practice Address - Country:US
Practice Address - Phone:323-783-6151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-15
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115353207YP0228X
PAMD439609207YP0228X
PAMT197146207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology