Provider Demographics
NPI:1265492771
Name:NGUYEN, JESSICA CHI (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CHI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 N 5TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3711
Mailing Address - Country:US
Mailing Address - Phone:626-358-2500
Mailing Address - Fax:
Practice Address - Street 1:51 N 5TH AVE
Practice Address - Street 2:201
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3710
Practice Address - Country:US
Practice Address - Phone:626-676-6273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69259208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics