Provider Demographics
NPI:1407388010
Name:NGUYEN, NGAN THI KIM (DO)
Entity Type:Individual
Prefix:
First Name:NGAN
Middle Name:THI KIM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 N CENTURY ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-4624
Mailing Address - Country:US
Mailing Address - Phone:901-462-4805
Mailing Address - Fax:
Practice Address - Street 1:THE ONCOLOGY INSTITUTE OF HOPE AND INNOVATION
Practice Address - Street 2:4646 BROCKTON AVE. #203
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506
Practice Address - Country:US
Practice Address - Phone:951-394-7028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-02
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A17494207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology