Provider Demographics
NPI:1760864821
Name:DUC NGUYEN CORPORATION
Entity Type:Organization
Organization Name:DUC NGUYEN CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DUC
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-414-5092
Mailing Address - Street 1:10900 WESTMINSTER AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4918
Mailing Address - Country:US
Mailing Address - Phone:714-414-5092
Mailing Address - Fax:814-845-1999
Practice Address - Street 1:10900 WESTMINSTER AVE STE 8
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4918
Practice Address - Country:US
Practice Address - Phone:714-414-5092
Practice Address - Fax:814-845-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4494213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty