Provider Demographics
NPI:1811307069
Name:NGUYEN, THOMAS X (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:X
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 1:5210 VAN GOGH LN
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-1912
Mailing Address - Country:US
Mailing Address - Phone:202-812-2498
Mailing Address - Fax:
Practice Address - Street 1:3750 CONVOY ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3770
Practice Address - Country:US
Practice Address - Phone:858-278-8031
Practice Address - Fax:858-278-1708
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA172071207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery