Provider Demographics
NPI:1720083181
Name:NGUYEN, LUC SINH (MD)
Entity Type:Individual
Prefix:DR
First Name:LUC
Middle Name:SINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14571 MAGNOLIA ST
Mailing Address - Street 2:STE 208
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5576
Mailing Address - Country:US
Mailing Address - Phone:714-438-0082
Mailing Address - Fax:714-438-0072
Practice Address - Street 1:14571 MAGNOLIA ST
Practice Address - Street 2:STE 208
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5576
Practice Address - Country:US
Practice Address - Phone:714-438-0082
Practice Address - Fax:714-438-0072
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66417207R00000X, 207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18136Medicare ID - Type UnspecifiedMEDICARE GROUP ID
CAWG66417BMedicare ID - Type UnspecifiedMEDICARE MEMBER ID
CAC45085Medicare UPIN