Basic Information
| Provider Information | |||||||||
| NPI: | 1407235625 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | DAO | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 S BEACH BLVD SPC 18 | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928041833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144687972 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10362 BOLSA AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145312091 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2015 | ||||||||
| LastUpdateDate: | 08/24/2018 | ||||||||
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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 | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | A143752 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.