Basic Information
| Provider Information | |||||||||
| NPI: | 1144245366 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | TUAN | ||||||||
| MiddleName: | NGOC | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28078 BAXTER RD STE 320 | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925631404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512464546 | ||||||||
| FaxNumber: | 9516729036 | ||||||||
| Practice Location | |||||||||
| Address1: | 28078 BAXTER RD STE 320 | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925631404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512464546 | ||||||||
| FaxNumber: | 9516729036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 11/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A64605 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.