Provider Demographics
NPI:1588195432
Name:NGUYEN, LUC-HA HOANG (MD)
Entity Type:Individual
Prefix:
First Name:LUC-HA
Middle Name:HOANG
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 1:17762 BEACH BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6860
Mailing Address - Country:US
Mailing Address - Phone:714-848-0080
Mailing Address - Fax:
Practice Address - Street 1:17762 BEACH BLVD STE 220
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6860
Practice Address - Country:US
Practice Address - Phone:714-848-0080
Practice Address - Fax:714-665-4679
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA164168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine