Organization Name: | TOM LE NGUYEN D.O. INC |
NPI Number: | 1760638761 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOM L NGUYEN (PRESIDENT) |
Mailing Address: | 625 E Valley Blvd Suite H & I San Gabriel |
State: | CA US |
Postal Code: | 917763591 |
Phone Number: | 6265724658 |
Fax Number: | 6265724336 |
NPI Enumeration Date: | 08/11/2008 |
NPI Last Update Date: | 08/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |