Provider Demographics
NPI:1083788046
Name:NGUYEN, NHON THI (MD)
Entity Type:Individual
Prefix:
First Name:NHON
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CAPE FRIO
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-2130
Mailing Address - Country:US
Mailing Address - Phone:909-528-5959
Mailing Address - Fax:909-798-4618
Practice Address - Street 1:385 TERRACINA BLVD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-3801
Practice Address - Country:US
Practice Address - Phone:909-798-2517
Practice Address - Fax:909-798-4618
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A352640207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A352640Medicaid
00A352640Medicare ID - Type Unspecified
D34051Medicare UPIN