Provider Demographics
NPI:1073759163
Name:NGUYEN, THINH VAN (MD)
Entity Type:Individual
Prefix:DR
First Name:THINH
Middle Name:VAN
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 1:2470 ALVIN AVE
Mailing Address - Street 2:SUITE 70
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1664
Mailing Address - Country:US
Mailing Address - Phone:408-223-0505
Mailing Address - Fax:408-223-9791
Practice Address - Street 1:2470 ALVIN AVE
Practice Address - Street 2:SUITE 70
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1664
Practice Address - Country:US
Practice Address - Phone:408-223-0505
Practice Address - Fax:408-223-9791
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine