Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 46905 | CA |
Y | 213EG0000X | General Practice | 46905 | CA |
NPI | 1003905068 |
---|---|
Provider Name | Dr. Duy Duc Nguyen |
First Address | San Diego, CA 92104 |
Second Address | San Diego, CA 92104-3034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 20/05/2008 |