Provider Demographics
NPI:1811966492
Name:NGUYEN, HUU NGOC (DO)
Entity type:Individual
Prefix:DR
First Name:HUU
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:22624 WILDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3228
Mailing Address - Country:US
Mailing Address - Phone:707-334-3825
Mailing Address - Fax:
Practice Address - Street 1:1990 N CALIFORNIA BLVD
Practice Address - Street 2:SUITE 400 VEP HEALTH CARE, INC
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:925-225-5837
Practice Address - Fax:925-225-5838
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A322201Medicare ID - Type Unspecified
H52197Medicare UPIN