1962480616 NPI number — DR. HIEP T NGUYEN MD

Table of content: DR. HIEP T NGUYEN MD (NPI 1962480616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962480616 NPI number — DR. HIEP T NGUYEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
HIEP
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962480616
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 S DOBSON RD
Provider Second Line Business Mailing Address:
CARSON CHILDREN'S MEDICAL CENTER
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85202-4707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-488-1943
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 S DOBSON RD
Provider Second Line Business Practice Location Address:
CARSON CHILDREN'S MEDICAL CENTER
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85202-4707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
857-488-1943
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  221176 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2075211 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P3604365 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0033264 . This is a "NHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900467 . This is a "UNI7" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900467 . This is a "UNI1" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30205178 . This is a "WNH" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA14464 . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z11048 . This is a "HEALT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000028270 . This is a "BMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11273 . This is a "HNE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 80862 . This is a "FCHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900467 . This is a "METRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4656949 . This is a "CIG2" identifier . This identifiers is of the category "OTHER".
  • Identifier: 469376 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900467 . This is a "UNI4" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3572875 . This is a "AETPP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3572875 . This is a "AETUS" identifier . This identifiers is of the category "OTHER".




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