Provider Demographics
NPI:1083961593
Name:NGUYEN, TUAN CUU (MOT)
Entity Type:Individual
Prefix:MR
First Name:TUAN
Middle Name:CUU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13075 BLACKBIRD ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-2902
Mailing Address - Country:US
Mailing Address - Phone:714-530-6322
Mailing Address - Fax:
Practice Address - Street 1:13075 BLACKBIRD ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2902
Practice Address - Country:US
Practice Address - Phone:714-530-6322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT13692225X00000X
NJ46TR00477400225X00000X
FLOT20777225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist