Basic Information
| Provider Information | |||||||||
| NPI: | 1588688832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | HUNG | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10069 | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924230069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093354188 | ||||||||
| FaxNumber: | 9093351936 | ||||||||
| Practice Location | |||||||||
| Address1: | 7223 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923465869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098621191 | ||||||||
| FaxNumber: | 9098644269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 08/25/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A5841 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.