Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | A78574 | CA |
NPI | 1023011384 |
---|---|
Provider Name | Dr. An Duy Nguyen |
First Address | Long Beach, CA 90813-3244 |
Second Address | Huntington Beach, CA 92648-2996 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 09/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A785740 | (05) | CA |
I05738 | (02) | CA |