Provider Demographics
NPI:1073517306
Name:NGUYEN, HUY ANH (MD)
Entity Type:Individual
Prefix:
First Name:HUY
Middle Name:ANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 MONTPELIER DR STE B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1673
Mailing Address - Country:US
Mailing Address - Phone:408-347-9001
Mailing Address - Fax:408-347-9004
Practice Address - Street 1:2331 MONTPELIER DR STE B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1673
Practice Address - Country:US
Practice Address - Phone:408-347-9001
Practice Address - Fax:408-347-9004
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61818207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A61818Medicaid
CA00A61818Medicaid
CA00A61818Medicare ID - Type Unspecified