Provider Demographics
NPI:1184729626
Name:NGUYEN, TANYA THUY (MD)
Entity type:Individual
Prefix:DR
First Name:TANYA
Middle Name:THUY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:320 S GARFIELD AVE
Mailing Address - Street 2:SUITE 288
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3886
Mailing Address - Country:US
Mailing Address - Phone:626-607-0288
Mailing Address - Fax:626-607-0399
Practice Address - Street 1:320 S GARFIELD AVE
Practice Address - Street 2:SUITE 288
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3886
Practice Address - Country:US
Practice Address - Phone:626-607-0288
Practice Address - Fax:626-607-0399
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG78163208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics