Provider Demographics
NPI:1912469792
Name:NGUYEN, BRIAN JONATHAN (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JONATHAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27420 TOURNEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5631
Mailing Address - Country:US
Mailing Address - Phone:661-259-3937
Mailing Address - Fax:661-259-3907
Practice Address - Street 1:27420 TOURNEY RD STE 100
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5631
Practice Address - Country:US
Practice Address - Phone:661-259-3937
Practice Address - Fax:661-259-3904
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2024-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT221626207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMT221626Medicaid