Doctor Name: | DR. CUNG VAN NGUYEN |
NPI Number: | 1346292083 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A40241 |
Business Practice Address: | 3102 East Highland Ave Patton, CA - 92369 |
Business Phone Number: | 9094257000 |
Business Fax Number: | 9094257520 |
Mailing Address: | 1600 9th Street, Room 205 Mailstop 2 3 SACRAMENTO |
State: | CA |
Postal Code: | 958146414 |
Phone Number: | 9166542431 |
Fax Number: | 9166543186 |
NPI Enumeration Date: | 05/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A40241 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |