Provider Demographics
NPI:1821331802
Name:NGUYEN, HONG DUC THANH
Entity Type:Individual
Prefix:
First Name:HONG DUC
Middle Name:THANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15611 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7408
Mailing Address - Country:US
Mailing Address - Phone:775-230-5123
Mailing Address - Fax:
Practice Address - Street 1:15611 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7408
Practice Address - Country:US
Practice Address - Phone:775-230-5123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA771703163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health