Provider Demographics
NPI:1508906033
Name:NGUYEN, LIEN T (NP)
Entity Type:Individual
Prefix:
First Name:LIEN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27799 MEDICAL CENTER RD STE 310
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6400
Mailing Address - Country:US
Mailing Address - Phone:949-364-8509
Mailing Address - Fax:
Practice Address - Street 1:27799 MEDICAL CENTER RD STE 310
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6400
Practice Address - Country:US
Practice Address - Phone:949-364-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP14331363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner