Provider Demographics
NPI:1528386695
Name:NGUYEN, MICHAEL KHANG (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KHANG
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 1:12192 RANCHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3335
Mailing Address - Country:US
Mailing Address - Phone:714-552-7866
Mailing Address - Fax:
Practice Address - Street 1:12192 RANCHWOOD RD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3335
Practice Address - Country:US
Practice Address - Phone:714-552-7866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127282208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery