Provider Demographics
NPI:1679895544
Name:NGUYEN GRECO, VAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VAN
Middle Name:
Last Name:NGUYEN GRECO
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 1:101 THE CITY DR S
Mailing Address - Street 2:BLDG 56, SUITE 600
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3201
Mailing Address - Country:US
Mailing Address - Phone:714-456-6933
Mailing Address - Fax:714-456-7658
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:BLDG 56, SUITE 600
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-6933
Practice Address - Fax:714-456-7658
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA638242080C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics