Provider Demographics
NPI:1114947405
Name:NGUYEN, CHRISTINE UYEN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:UYEN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:U
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:29798 HAUN RD
Mailing Address - Street 2:STE 104
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-6541
Mailing Address - Country:US
Mailing Address - Phone:951-301-9339
Mailing Address - Fax:
Practice Address - Street 1:29798 HAUN RD
Practice Address - Street 2:STE 104
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-6541
Practice Address - Country:US
Practice Address - Phone:951-301-9339
Practice Address - Fax:951-301-3980
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64451207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG98130Medicare UPIN