Provider Demographics
NPI:1205364015
Name:NGUYEN, CHI HONG (NP)
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:HONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12811 EL REY PLACE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840
Mailing Address - Country:US
Mailing Address - Phone:714-589-5012
Mailing Address - Fax:
Practice Address - Street 1:8201 NEWMAN AVE 101
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:CA
Practice Address - Zip Code:92647
Practice Address - Country:US
Practice Address - Phone:714-402-0090
Practice Address - Fax:714-456-3487
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005841207Q00000X
CANP95005841363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty