Provider Demographics
NPI:1376994269
Name:NGUYEN, NGAN T (DPM)
Entity type:Individual
Prefix:DR
First Name:NGAN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 N ORACLE RD APT 155
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5401
Mailing Address - Country:US
Mailing Address - Phone:847-691-3529
Mailing Address - Fax:
Practice Address - Street 1:16427 N SCOTTSDALE RD STE 410
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-7102
Practice Address - Country:US
Practice Address - Phone:888-495-4489
Practice Address - Fax:602-325-0169
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD-001150213E00000X
CAE5564213E00000X
IN07001438A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300080939Medicaid
IN1102822889OtherANTHEM BCBS