Provider Demographics
NPI:1780850198
Name:NGUYEN, CHIDAO L (DO)
Entity Type:Individual
Prefix:
First Name:CHIDAO
Middle Name:L
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 1:9353 BOLSA AVE
Mailing Address - Street 2:STE E62
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5951
Mailing Address - Country:US
Mailing Address - Phone:800-461-4651
Mailing Address - Fax:714-333-4838
Practice Address - Street 1:9353 BOLSA AVE
Practice Address - Street 2:STE E62
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5951
Practice Address - Country:US
Practice Address - Phone:800-461-4651
Practice Address - Fax:714-333-4838
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A10338207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine