Provider Demographics
NPI:1043326226
Name:NGUYEN, NANG (DO)
Entity Type:Individual
Prefix:DR
First Name:NANG
Middle Name:
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 1:200 JOSE FIGUERES AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1500
Mailing Address - Country:US
Mailing Address - Phone:408-929-5610
Mailing Address - Fax:408-929-5215
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1500
Practice Address - Country:US
Practice Address - Phone:408-929-5610
Practice Address - Fax:408-929-5215
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8813208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A88131Medicare ID - Type Unspecified
CAI08069Medicare UPIN