Provider Demographics
NPI:1578534020
Name:NGUYEN, HENRY H (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:H
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 77365
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92877-0112
Mailing Address - Country:US
Mailing Address - Phone:909-880-2000
Mailing Address - Fax:909-466-8410
Practice Address - Street 1:8241 ROCHESTER AVE STE 130
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0713
Practice Address - Country:US
Practice Address - Phone:909-880-2000
Practice Address - Fax:909-466-8410
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG83603207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1043409022Medicaid
CA1043409022Medicaid
CABS757Medicare PIN