Provider Demographics
NPI:1184002412
Name:DR QUANG BINH NGUYEN INC
Entity Type:Organization
Organization Name:DR QUANG BINH NGUYEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUANG BINH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-265-9913
Mailing Address - Street 1:202 N EUCLID ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-3006
Mailing Address - Country:US
Mailing Address - Phone:714-265-9913
Mailing Address - Fax:714-265-9916
Practice Address - Street 1:202 N EUCLID ST STE 103
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-3006
Practice Address - Country:US
Practice Address - Phone:714-265-9913
Practice Address - Fax:714-265-9916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty