Provider Demographics
NPI:1649357732
Name:NGUYEN, STEVE (DO)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 ATLANTIC AVE STE 808
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3410
Mailing Address - Country:US
Mailing Address - Phone:562-473-4471
Mailing Address - Fax:
Practice Address - Street 1:1045 ATLANTIC AVE STE 808
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3410
Practice Address - Country:US
Practice Address - Phone:562-473-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7028207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX70281Medicaid
CAW20A7028DMedicare ID - Type Unspecified
CA00AX70281Medicaid