Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A124621 | CA |
N | 208600000X | Surgeon | A124621 | CA |
Y | 2086X0206X | Surgical Oncologist | A124621 | CA |
NPI | 1457650707 |
---|---|
Provider Name | Andrew Nguyen |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Torrance, CA 90503-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 19/11/2020 |