1407097561 NPI number — H. Q. NGUYEN, MD, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407097561 NPI number — H. Q. NGUYEN, MD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H. Q. NGUYEN, MD, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KOALA PEDIATRIC ENDOCRINOLOGY & DIABETES, INC.
Provider Other Organization Name Type Code:
3
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:
1407097561
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7055 N CHESTNUT AVE
Provider Second Line Business Mailing Address:
SUITE #103
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93720-0350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-840-2170
Provider Business Mailing Address Fax Number:
559-840-1204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7055 N. CHESTNUT AVE.
Provider Second Line Business Practice Location Address:
STE # 103
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93720-0350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-840-2170
Provider Business Practice Location Address Fax Number:
559-840-1204
Provider Enumeration Date:
03/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
HUONG
Authorized Official Middle Name:
QUYNH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
559-840-2170

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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