Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | A136672 | CA |
NPI | 1437492147 |
---|---|
Provider Name | Jenna T Nguyen |
First Address | Los Angeles, CA 90074-2244 |
Second Address | Menlo Park, CA 94025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 01/10/2018 |