Provider Demographics
NPI:1134212962
Name:LOUIE HOANG NGUYEN MD
Entity type:Organization
Organization Name:LOUIE HOANG NGUYEN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-792-3914
Mailing Address - Street 1:3858 W CARSON ST
Mailing Address - Street 2:STE 121
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6709
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:310-792-3621
Practice Address - Street 1:2880 ATLANTIC AVE
Practice Address - Street 2:STE 180
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1714
Practice Address - Country:US
Practice Address - Phone:310-792-3914
Practice Address - Fax:310-792-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72589207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF08413Medicare UPIN
W19283Medicare PIN