Basic Information
| Provider Information | |||||||||
| NPI: | 1790173292 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NGUYEN | ||||||||
| FirstName: | MY-LINH | ||||||||
| MiddleName: | THI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1450 TREAT BLVD # 300 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945972168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259522828 | ||||||||
| FaxNumber: | 9256893857 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 N WIGET LN STE 207 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945985901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259377740 | ||||||||
| FaxNumber: | 9259339868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2015 | ||||||||
| LastUpdateDate: | 09/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | A129274 | CA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VF0040X | A129274 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
No ID Information.