Provider Demographics
NPI:1619921095
Name:NGUYEN, HUNG HUU (MD)
Entity Type:Individual
Prefix:DR
First Name:HUNG
Middle Name:HUU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10362 BOLSA AVENUE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6763
Mailing Address - Country:US
Mailing Address - Phone:714-531-2091
Mailing Address - Fax:714-531-1403
Practice Address - Street 1:10362 BOLSA AVENUE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6763
Practice Address - Country:US
Practice Address - Phone:714-531-2091
Practice Address - Fax:714-531-1403
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A342500Medicaid
C35434Medicare UPIN
CA00A342500Medicaid