Provider Demographics
NPI:1598833642
Name:NGUYEN, LAM DUC (BA, MSTM, DTEFL)
Entity Type:Individual
Prefix:
First Name:LAM
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:BA, MSTM, DTEFL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4864 MIRAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-1004
Mailing Address - Country:US
Mailing Address - Phone:408-244-4733
Mailing Address - Fax:408-244-3090
Practice Address - Street 1:232 E GISH RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-4706
Practice Address - Country:US
Practice Address - Phone:408-876-4207
Practice Address - Fax:408-876-4230
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4738OtherCOUNTY ID