Provider Demographics
NPI:1205890498
Name:NGUYEN, NATHALIE T (MD)
Entity type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:DEPT OF RADIATION ONCOLOGY
Mailing Address - Street 2:10725 INTERNATIONAL DRIVE
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670
Mailing Address - Country:US
Mailing Address - Phone:916-631-2730
Mailing Address - Fax:916-631-2710
Practice Address - Street 1:10725 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-7967
Practice Address - Country:US
Practice Address - Phone:916-631-2730
Practice Address - Fax:916-631-2710
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA895452085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A895450Medicaid
CAI10766Medicare UPIN
CA00A895450Medicaid