Provider Demographics
NPI:1255590444
Name:NGUYEN, HUNG PHUOC (MD)
Entity type:Individual
Prefix:DR
First Name:HUNG
Middle Name:PHUOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:23326 HAWTHORNE BLVD 200
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3756
Mailing Address - Country:US
Mailing Address - Phone:310-257-7205
Mailing Address - Fax:310-598-3119
Practice Address - Street 1:2841 LOMITA BLVD 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5110
Practice Address - Country:US
Practice Address - Phone:310-517-8952
Practice Address - Fax:310-517-9565
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2015-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA126528207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA110134Medicare PIN