Provider Demographics
NPI:1336110352
Name:NGUYEN HUU, M.D., INC
Entity Type:Organization
Organization Name:NGUYEN HUU, M.D., INC
Other - Org Name:HUU NGUYEN, M.D., INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUU
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-957-0040
Mailing Address - Street 1:1220 HEMLOCK WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3650
Mailing Address - Country:US
Mailing Address - Phone:714-957-0040
Mailing Address - Fax:714-957-0768
Practice Address - Street 1:1220 HEMLOCK WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3650
Practice Address - Country:US
Practice Address - Phone:714-957-0040
Practice Address - Fax:714-957-0768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-28
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32220207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A322200Medicaid
A32220Medicare ID - Type Unspecified
CA00A322200Medicaid