Provider Demographics
NPI:1255471975
Name:NGUYEN, HUONG QUYNH (MD)
Entity Type:Individual
Prefix:
First Name:HUONG
Middle Name:QUYNH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HUONG
Other - Middle Name:NGUYEN
Other - Last Name:BARAGHANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7055 N CHESTNUT AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0350
Mailing Address - Country:US
Mailing Address - Phone:559-840-2170
Mailing Address - Fax:559-840-1204
Practice Address - Street 1:7055 N CHESTNUT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0350
Practice Address - Country:US
Practice Address - Phone:559-840-2170
Practice Address - Fax:559-840-1204
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA953692080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-30962OtherKANSAS MEDICAL LICENSE
MO2005033053OtherMISSOURI MEDICAL LICENSE