Provider Demographics
NPI:1477949519
Name:NGUYEN, XUAN-LOC VAN (DO)
Entity Type:Individual
Prefix:
First Name:XUAN-LOC
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 PLACER ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1170
Mailing Address - Country:US
Mailing Address - Phone:530-246-5710
Mailing Address - Fax:530-244-7846
Practice Address - Street 1:550 W RANCH VIEW DR STE 2005
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5397
Practice Address - Country:US
Practice Address - Phone:916-295-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A18834207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine