Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 40381 | CA |
NPI | 1003019365 |
---|---|
Provider Name | Dr. Timothy Thoai Nguyen |
First Address | Milpitas, CA 95035-6818 |
Second Address | Milpitas, CA 95035-6818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 08/07/2007 |