Provider Demographics
NPI:1932134699
Name:NGUYEN, GIAO T
Entity Type:Individual
Prefix:
First Name:GIAO
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5911 HEIL AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-3752
Mailing Address - Country:US
Mailing Address - Phone:714-377-2255
Mailing Address - Fax:
Practice Address - Street 1:5911 HEIL AVE
Practice Address - Street 2:SUITE F
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-3752
Practice Address - Country:US
Practice Address - Phone:714-377-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE 4628213ES0103X
CAE4628332B00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies