Provider Demographics
NPI:1487843306
Name:DAVIS B. NGUYEN, MD, INC
Entity Type:Organization
Organization Name:DAVIS B. NGUYEN, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-593-5356
Mailing Address - Street 1:10760 WARNER AVE
Mailing Address - Street 2:201
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3845
Mailing Address - Country:US
Mailing Address - Phone:714-593-5356
Mailing Address - Fax:714-593-5366
Practice Address - Street 1:10760 WARNER AVE
Practice Address - Street 2:201
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3845
Practice Address - Country:US
Practice Address - Phone:714-593-5356
Practice Address - Fax:714-593-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84628207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty