Provider Demographics
NPI:1609927722
Name:NGUYEN, THUY-ANH (DO)
Entity Type:Individual
Prefix:DR
First Name:THUY-ANH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9862 CHAPMAN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-2726
Mailing Address - Country:US
Mailing Address - Phone:714-418-2040
Mailing Address - Fax:714-418-2045
Practice Address - Street 1:9862 CHAPMAN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-2726
Practice Address - Country:US
Practice Address - Phone:714-418-2040
Practice Address - Fax:714-418-2045
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7243207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
W13424Medicare ID - Type UnspecifiedGROUP MEDICARE ID NUMBER
CAEH888ZMedicare UPIN