Provider Demographics
NPI:1568756468
Name:NGUYEN, CYNTHIA VAN (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:909 S FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2625
Mailing Address - Country:US
Mailing Address - Phone:626-389-9300
Mailing Address - Fax:626-389-9336
Practice Address - Street 1:909 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2625
Practice Address - Country:US
Practice Address - Phone:626-389-9300
Practice Address - Fax:626-389-9336
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2018-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA151630207XP3100X
CA151630207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery