Provider Demographics
NPI:1518922061
Name:HANH MY NGUYEN, MD, INC.
Entity Type:Organization
Organization Name:HANH MY NGUYEN, MD, INC.
Other - Org Name:HP FAMILY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HANH
Authorized Official - Middle Name:MY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-531-8572
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95151-1850
Mailing Address - Country:US
Mailing Address - Phone:408-531-8572
Mailing Address - Fax:408-531-8574
Practice Address - Street 1:1692 TULLY RD
Practice Address - Street 2:SUITE # 10
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2549
Practice Address - Country:US
Practice Address - Phone:408-531-8572
Practice Address - Fax:408-531-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0095370Medicaid
CAGR0095370Medicaid