Provider Demographics
NPI:1558564674
Name:NGUYEN, DANIELLE THANH-AN (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:THANH-AN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 DOLORES TER
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1010
Mailing Address - Country:US
Mailing Address - Phone:917-545-3072
Mailing Address - Fax:
Practice Address - Street 1:1411 E 31ST ST
Practice Address - Street 2:SUITE K6 PEDIATRICS
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602
Practice Address - Country:US
Practice Address - Phone:510-437-4887
Practice Address - Fax:510-437-4168
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93928208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics