Provider Demographics
NPI:1710055074
Name:NGUYEN, MICHAEL HUY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HUY
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 1:27520 HAWTHORNE BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3580
Mailing Address - Country:US
Mailing Address - Phone:310-706-4440
Mailing Address - Fax:310-706-4441
Practice Address - Street 1:27520 HAWTHORNE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3580
Practice Address - Country:US
Practice Address - Phone:310-706-4440
Practice Address - Fax:310-706-4441
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA836202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A836200Medicaid
CA00A836200Medicaid
CAWA83620CMedicare PIN
CA00A836201Medicare PIN
CA00A8362011Medicare PIN
CA00A836204Medicare PIN
CA00A836209Medicare PIN
CAWA83620EMedicare PIN
CA00A836205Medicare PIN
CA00A836206Medicare PIN
CAWA83620AMedicare PIN
CA00A8362010Medicare PIN
CA00A836202Medicare PIN
CA00A836207Medicare PIN
CA00A836208Medicare PIN
CAWA83620DMedicare PIN
CA00A836200Medicare PIN
CA00A836203Medicare PIN
CAWA83620FMedicare PIN