Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 102060 | CA |
NPI | 1245680040 |
---|---|
Provider Name | Dr. Long-Giang Nguyen Chau |
First Address | Aliso Viejo, CA 92656-5241 |
Second Address | New York, NY 10010-4020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2016 |
Last Update Date | 02/04/2020 |