Provider Demographics
NPI:1790180065
Name:GIOI NGOC SMITH-NGUYEN MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:GIOI NGOC SMITH-NGUYEN MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIOI
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:SMITH-NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-589-4100
Mailing Address - Street 1:8851 CENTER DR
Mailing Address - Street 2:206
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3017
Mailing Address - Country:US
Mailing Address - Phone:619-589-4100
Mailing Address - Fax:619-589-4104
Practice Address - Street 1:8851 CENTER DR
Practice Address - Street 2:206
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3017
Practice Address - Country:US
Practice Address - Phone:619-589-4100
Practice Address - Fax:619-589-4104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61280207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1619198140OtherNPI