Provider Demographics
NPI:1093477606
Name:NGUYEN, QUAN (NMD)
Entity Type:Individual
Prefix:DR
First Name:QUAN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 LA VERGN WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2632
Mailing Address - Country:US
Mailing Address - Phone:714-623-5080
Mailing Address - Fax:
Practice Address - Street 1:9950 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4309
Practice Address - Country:US
Practice Address - Phone:949-490-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175L00000X
CAND1284175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath