Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A36682 | CA |
NPI | 1013976174 |
---|---|
Provider Name | Dr. Khoi N Nguyen |
First Address | Apple Valley, CA 92307-0070 |
Second Address | Apple Valley, CA 92307-1382 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2006 |
Last Update Date | 30/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A366820 | (05) | CA |
110013433 | RAILROAD MEDICARE (01) | |
A28159 | (02) |