Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 48725 | CA |
Y | 1223D0004X | Dentist Anesthesiologist | 48725 | CA |
NPI | 1033389945 |
---|---|
Provider Name | Dr. Mai-Phuong Nguyen Huynh |
First Address | San Diego, CA 92111-3762 |
Second Address | San Diego, CA 92111-3762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 20/02/2014 |