Provider Demographics
NPI:1780816645
Name:NGUYEN, PHIL HONG (MD)
Entity Type:Individual
Prefix:
First Name:PHIL
Middle Name:HONG
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 1:1777 S HARRISON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3925
Mailing Address - Country:US
Mailing Address - Phone:303-691-5989
Mailing Address - Fax:303-691-5993
Practice Address - Street 1:1777 S HARRISON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3925
Practice Address - Country:US
Practice Address - Phone:303-691-5989
Practice Address - Fax:303-691-5993
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38110208D00000X
CAC52886208D00000X
IN01054400A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice