Provider Demographics
NPI:1831586288
Name:NGUYEN TRINH, THANH NGOC (NP)
Entity type:Individual
Prefix:DR
First Name:THANH NGOC
Middle Name:
Last Name:NGUYEN TRINH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TRINH THANH
Other - Middle Name:NGOC
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:8462 POLDER CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6019
Mailing Address - Country:US
Mailing Address - Phone:818-939-1669
Mailing Address - Fax:
Practice Address - Street 1:180 N LOS ANGELES ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012
Practice Address - Country:US
Practice Address - Phone:213-356-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily