Provider Demographics
NPI:1881129047
Name:NGUYEN, MY AN CHAU (MD)
Entity type:Individual
Prefix:
First Name:MY AN
Middle Name:CHAU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MYAN
Other - Middle Name:CHAU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:806 KING ST
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2321
Mailing Address - Country:US
Mailing Address - Phone:213-235-5208
Mailing Address - Fax:
Practice Address - Street 1:701 S ATLANTIC BLVD STE 300
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-3846
Practice Address - Country:US
Practice Address - Phone:626-300-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA157269208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics