Provider Demographics
NPI:1902006075
Name:NGUYEN, JOHN DUC (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1201 W LA VETA AVE
Mailing Address - Street 2:CS, NEPHROLOGY
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4203
Mailing Address - Country:US
Mailing Address - Phone:714-509-8324
Mailing Address - Fax:714-509-4169
Practice Address - Street 1:1201 W LA VETA AVE
Practice Address - Street 2:CS, NEPHROLOGY
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4203
Practice Address - Country:US
Practice Address - Phone:714-509-8324
Practice Address - Fax:714-509-4169
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2013-03-25
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Provider Licenses
StateLicense IDTaxonomies
CAA1032122080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902006075Medicaid