Provider Demographics
NPI:1033138052
Name:NGUYEN-NGO, HUE (DO)
Entity Type:Individual
Prefix:
First Name:HUE
Middle Name:
Last Name:NGUYEN-NGO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 SUNNYSLOPE RD
Mailing Address - Street 2:SUITE # E-2
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5615
Mailing Address - Country:US
Mailing Address - Phone:831-630-1477
Mailing Address - Fax:831-630-1529
Practice Address - Street 1:930 SUNNYSLOPE RD
Practice Address - Street 2:SUITE # E-2
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5615
Practice Address - Country:US
Practice Address - Phone:831-630-1477
Practice Address - Fax:831-630-1529
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7593208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX75930Medicaid