Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | A115353 | CA |
N | 207YP0228X | Pediatric Otolaryngology | MD439609 | PA |
N | 207YP0228X | Pediatric Otolaryngology | MT197146 | PA |
NPI | 1962731281 |
---|---|
Provider Name | Dr. Carolyn V Nguyen |
First Address | Los Angeles, CA 90027-5814 |
Second Address | Los Angeles, CA 90027-5814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2009 |
Last Update Date | 30/11/2021 |