Provider Demographics
NPI:1558508291
Name:NGUYEN, HUNG
Entity Type:Individual
Prefix:
First Name:HUNG
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 MCCREERY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-2208
Mailing Address - Country:US
Mailing Address - Phone:408-609-6540
Mailing Address - Fax:
Practice Address - Street 1:10311 S DE ANZA BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3028
Practice Address - Country:US
Practice Address - Phone:408-609-6540
Practice Address - Fax:408-609-6540
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17542171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist