Provider Demographics
NPI:1578841607
Name:NGUYEN, RICHARD (CPO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4479 STONERIDGE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8448
Mailing Address - Country:US
Mailing Address - Phone:925-484-6400
Mailing Address - Fax:925-484-6497
Practice Address - Street 1:4479 STONERIDGE DR
Practice Address - Street 2:SUITE A
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8448
Practice Address - Country:US
Practice Address - Phone:925-484-6400
Practice Address - Fax:925-484-6497
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter