Provider Demographics
NPI:1689463358
Name:NGUYEN, VU
Entity type:Individual
Prefix:
First Name:VU
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2273 SUNRISE TRL
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-4410
Mailing Address - Country:US
Mailing Address - Phone:408-833-5028
Mailing Address - Fax:
Practice Address - Street 1:3650 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-8154
Practice Address - Country:US
Practice Address - Phone:928-704-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program