Provider Demographics
NPI:1831107911
Name:NGUYEN, GIANG (MD)
Entity Type:Individual
Prefix:
First Name:GIANG
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
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:DEPT LA 21613
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-1613
Mailing Address - Country:US
Mailing Address - Phone:949-263-8620
Mailing Address - Fax:949-263-1639
Practice Address - Street 1:2320 BATH STREET
Practice Address - Street 2:SUITE 208
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5322
Practice Address - Country:US
Practice Address - Phone:805-682-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA872692085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A872690OtherBLUE SHIELD
CA00A872690Medicaid
CAWA87269MMedicare PIN
CAWA87269GMedicare PIN
CAWA87269IMedicare PIN
CAWA87269KMedicare PIN
CAWA87269JMedicare PIN
CAWA87269FMedicare PIN
CAWA87269HMedicare PIN
CAI36451Medicare UPIN
CAWA87269LMedicare PIN