Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A142209 | CA |
NPI | 1023488806 |
---|---|
Provider Name | Hung Hoang Nguyen |
First Address | San Diego, CA 92163-3865 |
Second Address | La Jolla, CA 92037-1212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2015 |
Last Update Date | 29/07/2019 |