Provider Demographics
NPI:1982043279
Name:NGUYEN, NGAN HONG (MD)
Entity Type:Individual
Prefix:DR
First Name:NGAN
Middle Name:HONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HONG-NGAN
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3955 BONITA RD
Mailing Address - Street 2:FAMILYN MEDICINE DEPARTMENT
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-1230
Mailing Address - Country:US
Mailing Address - Phone:619-409-6290
Mailing Address - Fax:
Practice Address - Street 1:3955 BONITA RD
Practice Address - Street 2:FAMILYN MEDICINE DEPARTMENT
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902-1230
Practice Address - Country:US
Practice Address - Phone:619-409-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine