Provider Demographics
NPI:1457676983
Name:SON VAN NGUYEN MD INC
Entity Type:Organization
Organization Name:SON VAN NGUYEN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SON
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-722-7786
Mailing Address - Street 1:7101 MLK JR WAY S
Mailing Address - Street 2:SUITE # 217
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3594
Mailing Address - Country:US
Mailing Address - Phone:206-722-7786
Mailing Address - Fax:206-722-7784
Practice Address - Street 1:7101 MLK JR WAY S
Practice Address - Street 2:SUITE # 217
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3594
Practice Address - Country:US
Practice Address - Phone:206-722-7786
Practice Address - Fax:206-722-7884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-27
Last Update Date:2010-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty