Provider Demographics
NPI:1285820191
Name:NGUYEN, KIMCHUYEN THI
Entity Type:Individual
Prefix:
First Name:KIMCHUYEN
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIMMY
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12966 EUCLID ST
Mailing Address - Street 2:#495
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840
Mailing Address - Country:US
Mailing Address - Phone:714-461-3687
Mailing Address - Fax:714-591-5015
Practice Address - Street 1:12966 EUCLID ST
Practice Address - Street 2:#495
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840
Practice Address - Country:US
Practice Address - Phone:714-461-3687
Practice Address - Fax:714-591-5015
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist