Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A140731 | CA |
Y | 111NI0900X | Internist | A140731 | CA |
NPI | 1003256843 |
---|---|
Provider Name | Dr. Tan Michael Nguyen |
First Address | Mountain View, CA 94040-6203 |
Second Address | Sunnyvale, CA 94086-6386 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 10/10/2016 |