Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25153 | OK |
N | 2080P0210X | Pediatric Nephrologist | A108993 | CA |
Y | 2080P0210X | Pediatric Nephrologist | MD2021-0528 | NM |
NPI | 1235289364 |
---|---|
Provider Name | Dr. Lieuko Nguyen |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-2746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 22/07/2021 |