Provider Demographics
NPI:1710449822
Name:NGUYEN-DANG, PETER DUY-MINH (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:DUY-MINH
Last Name:NGUYEN-DANG
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 1:14536 BROOKHURST ST STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5788
Mailing Address - Country:US
Mailing Address - Phone:714-531-2548
Mailing Address - Fax:
Practice Address - Street 1:14536 BROOKHURST ST STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5788
Practice Address - Country:US
Practice Address - Phone:714-531-2548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-05
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA178332207R00000X
CAPTL611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine