Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 152137 | CA |
NPI | 1124481809 |
---|---|
Provider Name | Amie Nguyen |
First Address | Glendale, CA 91203-2971 |
Second Address | Glendale, CA 91202-2358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2016 |
Last Update Date | 19/07/2021 |