Provider Demographics
NPI:1518424829
Name:TRI THUONG NGUYEN MD APC
Entity Type:Organization
Organization Name:TRI THUONG NGUYEN MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SULPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-303-6542
Mailing Address - Street 1:7345 LINDA VISTA RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-5800
Mailing Address - Country:US
Mailing Address - Phone:858-277-5463
Mailing Address - Fax:
Practice Address - Street 1:7345 LINDA VISTA RD STE A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-5800
Practice Address - Country:US
Practice Address - Phone:858-277-5463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty