Provider Demographics
NPI:1013923481
Name:NGUYEN, TIEN (MD)
Entity Type:Individual
Prefix:
First Name:TIEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 CENTENNIAL PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2011
Mailing Address - Country:US
Mailing Address - Phone:661-588-1150
Mailing Address - Fax:661-241-4052
Practice Address - Street 1:4901 CENTENNIAL PLAZA WAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2011
Practice Address - Country:US
Practice Address - Phone:661-588-1150
Practice Address - Fax:661-241-4052
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91766207Q00000X, 208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery