Provider Demographics
NPI:1770528028
Name:NGUYEN, ELIZABETH U (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:U
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3801 LAS POSAS RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1427
Mailing Address - Country:US
Mailing Address - Phone:805-389-0099
Mailing Address - Fax:805-389-4884
Practice Address - Street 1:3801 LAS POSAS RD
Practice Address - Street 2:SUITE 211
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1427
Practice Address - Country:US
Practice Address - Phone:805-389-0099
Practice Address - Fax:805-389-4884
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90331207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A903310OtherBCBS OF CA
CA00A903310Medicaid
CAP00472233OtherRR MEDICARE
CAP00472233OtherRR MEDICARE
CAP00472233Medicare PIN
CAWA90331CMedicare PIN
CA00A903310OtherBCBS OF CA