Provider Demographics
NPI:1205070794
Name:NGUYEN, AMY MAI (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MAI
Last Name:NGUYEN
Suffix:
Gender:F
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:PO BOX 17866
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92817-7866
Mailing Address - Country:US
Mailing Address - Phone:714-930-6989
Mailing Address - Fax:
Practice Address - Street 1:7219 WESTMINSTER BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4235
Practice Address - Country:US
Practice Address - Phone:714-930-6989
Practice Address - Fax:888-764-9650
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136004207Y00000X, 207Y00000X
TNMD50953207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology