Provider Demographics
NPI:1336325406
Name:NGUYEN, THUONG T (DPT)
Entity Type:Individual
Prefix:
First Name:THUONG
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7080 HOLLYWOOD BLVD
Mailing Address - Street 2:815
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6906
Mailing Address - Country:US
Mailing Address - Phone:323-957-9571
Mailing Address - Fax:323-957-9583
Practice Address - Street 1:7080 HOLLYWOOD BLVD
Practice Address - Street 2:815
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-6906
Practice Address - Country:US
Practice Address - Phone:323-957-9571
Practice Address - Fax:323-957-9583
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT34404174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist