Provider Demographics
NPI:1518031939
Name:NGUYEN, LUAN NGHI (MD)
Entity Type:Individual
Prefix:
First Name:LUAN
Middle Name:NGHI
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18080 BEACH BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1342
Mailing Address - Country:US
Mailing Address - Phone:714-375-0333
Mailing Address - Fax:714-375-0432
Practice Address - Street 1:18080 BEACH BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1342
Practice Address - Country:US
Practice Address - Phone:714-375-0333
Practice Address - Fax:714-375-0432
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG72660208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F66231Medicare UPIN