Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | A60676 | CA |
NPI | 1295823862 |
---|---|
Provider Name | Ly Anh Nguyen |
First Address | Torrance, CA 90505 |
Second Address | Torrance, CA 90505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 10/11/2009 |