Provider Demographics
NPI:1225808140
Name:NGUYEN, ANNY THUC
Entity Type:Individual
Prefix:
First Name:ANNY
Middle Name:THUC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 371104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92137-1104
Mailing Address - Country:US
Mailing Address - Phone:619-278-2400
Mailing Address - Fax:
Practice Address - Street 1:3990 OLD TOWN AVE STE C201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2933
Practice Address - Country:US
Practice Address - Phone:619-278-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator