| Dat Q Nguyen, MD, Inc | |
|
12865 Main St Ste 105 Garden Grove CA 92840-8205 | |
| (800) 560-9999 | |
| Not Available |
| Full Name | Dat Q Nguyen, MD, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12865 Main St Ste 105, Garden Grove, California |
| Authorized Official Name and Position | Dat Nguyen (OWNER) |
| Authorized Official Contact | 8186186850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dat Q Nguyen, MD, Inc 9891 Frederick Cir Huntington Beach CA 92646-3641 | Dat Q Nguyen, MD, Inc 12865 Main St Ste 105 Garden Grove CA 92840-8205 Ph: (800) 560-9999 |
| NPI Number | 1811530686 |
|---|---|
| Provider Enumeration Date | 10/23/2019 |
| Last Update Date | 10/23/2019 |
| Medicare PECOS PAC ID | 6507290632 |
|---|---|
| Medicare Enrollment ID | O20221223000753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811530686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Dat Q Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720092315 PECOS PAC ID: 0143254920 Enrollment ID: I20050921000526 |
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