Provider Demographics
NPI:1326618505
Name:NGUYEN, FRANCIS PHONG (FNP)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:PHONG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13801 OXNARD ST APT 110
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-3977
Mailing Address - Country:US
Mailing Address - Phone:949-690-1119
Mailing Address - Fax:
Practice Address - Street 1:13801 OXNARD ST APT 110
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-3977
Practice Address - Country:US
Practice Address - Phone:949-690-1119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95015357363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care