Provider Demographics
NPI:1376584599
Name:NGUYEN, LIEN HUONG (MD)
Entity Type:Individual
Prefix:DR
First Name:LIEN
Middle Name:HUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2449 S KING RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-1811
Mailing Address - Country:US
Mailing Address - Phone:408-238-1978
Mailing Address - Fax:408-238-2138
Practice Address - Street 1:2449 S KING RD
Practice Address - Street 2:SUITE 10
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1811
Practice Address - Country:US
Practice Address - Phone:408-238-1978
Practice Address - Fax:408-238-2138
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66030207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
91-2069126OtherFEDERAL TAX I.D. FOR CORP
CA7933833Medicaid
91-2069126OtherFEDERAL TAX I.D. FOR CORP
CA7933833Medicaid