Provider Demographics
NPI:1447763792
Name:BRIDGEWATER, ANH
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:
Last Name:BRIDGEWATER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANH
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1952 BADGERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-2544
Mailing Address - Country:US
Mailing Address - Phone:408-512-4298
Mailing Address - Fax:
Practice Address - Street 1:1952 BADGERWOOD LN
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-2544
Practice Address - Country:US
Practice Address - Phone:408-512-4298
Practice Address - Fax:408-512-4298
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant