Provider Demographics
NPI:1376635219
Name:NGUYEN, ADRIENNE J (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:J
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 1:1000 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3939
Mailing Address - Country:US
Mailing Address - Phone:650-596-8800
Mailing Address - Fax:650-596-8802
Practice Address - Street 1:1000 LAUREL ST
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3939
Practice Address - Country:US
Practice Address - Phone:650-596-8800
Practice Address - Fax:650-596-8802
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53504207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology