Doctor Name: | DR. BENJAMIN NGUYEN |
NPI Number: | 1558699827 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A 110128 |
Business Practice Address: | 9961 Sierra Ave 3rd Floor Anesthesia Administration Fontana, CA - 923356720 |
Business Phone Number: | 9093024857 |
Business Fax Number: | |
Mailing Address: | 9961 Sierra Ave, 3rd Floor Anesthesia Administration FONTANA |
State: | CA |
Postal Code: | 923356720 |
Phone Number: | 9093024857 |
Fax Number: | |
NPI Enumeration Date: | 11/25/2009 |
NPI Last Update Date: | 05/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A 110128 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |