Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 20A16094 | CA |
Y | 208000000X | Pediatrician | DR.0061983 | CO |
N | 2080P0202X | Pediatric Cardiologist | DR.0061983 | CO |
NPI | 1225491764 |
---|---|
Provider Name | Dr. Michael Nguyen |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 23/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1225491764 | (05) | CA |