Provider Demographics
NPI:1730144437
Name:NGUYEN, HANH MY (MD)
Entity Type:Individual
Prefix:
First Name:HANH
Middle Name:MY
Last Name:NGUYEN
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:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95151-1850
Mailing Address - Country:US
Mailing Address - Phone:408-531-8572
Mailing Address - Fax:408-531-8574
Practice Address - Street 1:1692 TULLY RD
Practice Address - Street 2:SUITE #10
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2549
Practice Address - Country:US
Practice Address - Phone:408-531-8572
Practice Address - Fax:408-531-8574
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68181207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A681810Medicaid
H19470Medicare UPIN
CA00A681811Medicare ID - Type Unspecified