Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 20A9575 | CA |
NPI | 1538240734 |
---|---|
Provider Name | Peter Trong Ngoc Nguyen |
First Address | Fountain Valley, CA 92708-6728 |
Second Address | Fountain Valley, CA 92708-6728 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 28/01/2021 |