Provider Demographics
NPI:1154657757
Name:GIAO T NGUYEN
Entity Type:Organization
Organization Name:GIAO T NGUYEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GIAO
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:951-658-2256
Mailing Address - Street 1:975 SAINT JOHN PL STE B
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4428
Mailing Address - Country:US
Mailing Address - Phone:951-658-2256
Mailing Address - Fax:951-658-8956
Practice Address - Street 1:975 SAINT JOHN PL STE B
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4428
Practice Address - Country:US
Practice Address - Phone:951-658-2256
Practice Address - Fax:951-658-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies