Provider Demographics
NPI:1073607446
Name:NGUYEN, TUAN HUU (MD)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:HUU
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 1:22030 SHERMAN WAY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1855
Mailing Address - Country:US
Mailing Address - Phone:818-884-7424
Mailing Address - Fax:818-884-6620
Practice Address - Street 1:22030 SHERMAN WAY
Practice Address - Street 2:SUITE 211
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1855
Practice Address - Country:US
Practice Address - Phone:818-884-7424
Practice Address - Fax:818-884-6620
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32393207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A323930Medicaid
CAA32393Medicare ID - Type Unspecified
CAA84348Medicare UPIN