Provider Demographics
NPI:1356417364
Name:NGUYEN, KIM-ANH THI (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:KIM-ANH
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 MASONIC AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-4417
Mailing Address - Country:US
Mailing Address - Phone:415-749-6647
Mailing Address - Fax:415-921-6184
Practice Address - Street 1:270 MASONIC AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-4417
Practice Address - Country:US
Practice Address - Phone:415-749-6647
Practice Address - Fax:415-921-6184
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72010207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA72010OtherMEDICAL LICENSE