Provider Demographics
NPI:1356311427
Name:NGUYEN, DON H (DO)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:H
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65274
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28265-0274
Mailing Address - Country:US
Mailing Address - Phone:800-377-8721
Mailing Address - Fax:304-523-2241
Practice Address - Street 1:271 TURN PIKE DR
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8149
Practice Address - Country:US
Practice Address - Phone:916-985-9300
Practice Address - Fax:916-355-1458
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2191435Medicaid
OH5619197341C1UOtherBLUECROSS BLUESHIELD
OHNG4074515Medicare ID - Type Unspecified
OH5619197341C1UOtherBLUECROSS BLUESHIELD