Provider Demographics
NPI:1972161255
Name:HOANG DUC NGUYEN, M.D., INC.
Entity type:Organization
Organization Name:HOANG DUC NGUYEN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HOANG
Authorized Official - Middle Name:DUC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-481-0118
Mailing Address - Street 1:22110 ROSCOE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3875
Mailing Address - Country:US
Mailing Address - Phone:818-481-0118
Mailing Address - Fax:818-584-8926
Practice Address - Street 1:22110 ROSCOE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-3875
Practice Address - Country:US
Practice Address - Phone:818-481-0118
Practice Address - Fax:818-584-8926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care