Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 44519 | CA |
Y | 213EG0000X | General Practice | 44519 | CA |
NPI | 1003024415 |
---|---|
Provider Name | Dr. Huong Thi Mai Nguyen |
First Address | San Jose, CA 95116-1209 |
Second Address | San Jose, CA 95116-1209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |