Basic Information
| Provider Information | |||||||||
| NPI: | 1356488290 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | THUY-HUYNH | ||||||||
| MiddleName: | TRINH | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 303 E VANDERBILT WAY | ||||||||
| Address2: | |||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924083551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093880810 | ||||||||
| FaxNumber: | 9098900281 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 E VANDERBILT WAY | ||||||||
| Address2: | |||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924083551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093880810 | ||||||||
| FaxNumber: | 9098900281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 11/03/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A67394 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.