Provider Demographics
NPI:1558503169
Name:THUY T M NGUYEN M D INC
Entity Type:Organization
Organization Name:THUY T M NGUYEN M D INC
Other - Org Name:CENTRAL URGENT MEDICAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THUY
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-841-4181
Mailing Address - Street 1:5131 NELLIE CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-5132
Mailing Address - Country:US
Mailing Address - Phone:213-841-4181
Mailing Address - Fax:520-843-4181
Practice Address - Street 1:8891 CENTRAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-1618
Practice Address - Country:US
Practice Address - Phone:909-297-3361
Practice Address - Fax:520-843-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75293261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A803220Medicaid
CA00A803220OtherBLUE SHIELD
CAP00205726OtherRAILROAD MEDICARE
CAI00313Medicare UPIN