Provider Demographics
NPI:1629066139
Name:NGUYEN, ANH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:
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 1:5026 FRUITRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-5301
Mailing Address - Country:US
Mailing Address - Phone:916-391-9497
Mailing Address - Fax:916-424-2711
Practice Address - Street 1:5026 FRUITRIDGE RD
Practice Address - Street 2:STE 1
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-5302
Practice Address - Country:US
Practice Address - Phone:916-391-9497
Practice Address - Fax:916-424-2711
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41601173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine