Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A91766 | CA |
N | 208200000X | Surgeon | A91766 | CA |
N | 208600000X | Surgeon | A91766 | CA |
Y | 2086S0129X | Vascular Surgeon | A91766 | CA |
NPI | 1013923481 |
---|---|
Provider Name | Tien Nguyen |
First Address | Bakersfield, CA 93312-2011 |
Second Address | Bakersfield, CA 93312-2011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 02/06/2011 |