Provider Demographics
NPI:1710209622
Name:NGUYEN, JOSEPH TUAN (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12942 HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-5809
Mailing Address - Country:US
Mailing Address - Phone:714-618-9540
Mailing Address - Fax:714-578-8629
Practice Address - Street 1:12942 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5809
Practice Address - Country:US
Practice Address - Phone:714-618-9540
Practice Address - Fax:714-578-8629
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine