Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A127281 | CA |
NPI | 1144588161 |
---|---|
Provider Name | Dr. David Nguyen |
First Address | Culver City, CA 90230-6007 |
Second Address | Lake Forest, CA 92630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2012 |
Last Update Date | 03/09/2018 |