Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A136004 | CA |
N | 207YP0228X | Pediatric Otolaryngology | MD50953 | TN |
NPI | 1205070794 |
---|---|
Provider Name | Dr. Amy Mai Nguyen |
First Address | Anaheim, CA 92817-7866 |
Second Address | Westminster, CA 92683-4235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2009 |
Last Update Date | 06/12/2020 |