Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | A115066 | CA |
NPI | 1174815815 |
---|---|
Provider Name | Von Ta Nguyen |
First Address | San Francisco, CA 94115-2903 |
Second Address | San Francisco, CA 94115-1925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2011 |
Last Update Date | 04/11/2021 |