Provider Demographics
NPI:1669558730
Name:NGUYEN, SCARLETT DONGDUY (OMD;LAC)
Entity type:Individual
Prefix:DR
First Name:SCARLETT
Middle Name:DONGDUY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OMD;LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 PEPPERTREE WAY
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-1917
Mailing Address - Country:US
Mailing Address - Phone:909-630-8385
Mailing Address - Fax:
Practice Address - Street 1:14726 RAMONA AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5730
Practice Address - Country:US
Practice Address - Phone:909-393-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10960171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist