Provider Demographics
NPI:1245203074
Name:NGUYEN, KHANG NGOC (MD)
Entity Type:Individual
Prefix:DR
First Name:KHANG
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2699 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2710
Mailing Address - Country:US
Mailing Address - Phone:562-426-3333
Mailing Address - Fax:562-933-0125
Practice Address - Street 1:2699 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2710
Practice Address - Country:US
Practice Address - Phone:562-426-3333
Practice Address - Fax:562-427-1876
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA80496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine