1972786747 NPI number — HENNY NGUYEN D.P.M., INC.

Table of content: NADIA ANDERSON DO, MPH (NPI 1356045884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972786747 NPI number — HENNY NGUYEN D.P.M., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENNY NGUYEN D.P.M., 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:
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:
1972786747
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14360 BROOKHURST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARDEN GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92843-4608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-531-9682
Provider Business Mailing Address Fax Number:
714-531-9686

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14360 BROOKHURST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARDEN GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92843-4608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-531-9682
Provider Business Practice Location Address Fax Number:
714-531-9686
Provider Enumeration Date:
12/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
HENNY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-531-9682

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5544238 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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