Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | A155807 | CA |
NPI | 1306100623 |
---|---|
Provider Name | Dr. Tin Toan Nguyen |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2012 |
Last Update Date | 06/05/2021 |