Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | A103212 | CA |
NPI | 1902006075 |
---|---|
Provider Name | Dr. John Duc Nguyen |
First Address | Orange, CA 92868-4203 |
Second Address | Orange, CA 92868-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 25/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1902006075 | (05) | CA |