Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 104952 | CA |
Y | 213EG0000X | General Practice | 104952 | CA |
NPI | 1003424946 |
---|---|
Provider Name | Trang Nguyen |
First Address | Oxnard, CA 93030-5093 |
Second Address | Oxnard, CA 93030-5427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2020 |
Last Update Date | 30/11/2020 |