Provider Demographics
NPI:1922620434
Name:NGUYEN, NINA T (R)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9315 BOLSA AVE # 899
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5902
Mailing Address - Country:US
Mailing Address - Phone:714-414-8312
Mailing Address - Fax:
Practice Address - Street 1:14571 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5574
Practice Address - Country:US
Practice Address - Phone:424-428-9275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA5361422471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging