Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 151630 | CA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A151630 | CA |
NPI | 1568756468 |
---|---|
Provider Name | Cynthia Van Nguyen |
First Address | Pasadena, CA 91105-2625 |
Second Address | Pasadena, CA 91105-2625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2011 |
Last Update Date | 02/02/2018 |