Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | G83603 | CA |
NPI | 1578534020 |
---|---|
Provider Name | Dr. Henry H Nguyen |
First Address | San Bernardino, CA 92411-1218 |
Second Address | San Bernardino, CA 92411-1218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 12/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043409022 | (05) | CA |
F93565 | (02) |