Provider Demographics
NPI:1023185030
Name:NGUYEN, RICHARD THE (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:THE
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15965 LOS GATOS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3415
Mailing Address - Country:US
Mailing Address - Phone:408-358-1855
Mailing Address - Fax:408-356-4183
Practice Address - Street 1:15965 LOS GATOS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3415
Practice Address - Country:US
Practice Address - Phone:408-358-1855
Practice Address - Fax:408-356-4183
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1813208600000X
CA20A10031208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABN7404039OtherDEA