Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 44228 | CA |
Y | 213EG0000X | General Practice | 44228 | CA |
NPI | 1003835570 |
---|---|
Provider Name | Paul Chau Nguyen |
First Address | San Lorenzo, CA 94580-1539 |
Second Address | San Lorenzo, CA 94580-1539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
44228 | DENTI-CAL (01) | CA |