| Khanh Bao Nguyen Md Inc | |
|
13830 Brookhurst St Garden Grove CA 92843-3121 | |
| (714) 467-4330 | |
| (714) 534-4575 |
| Full Name | Khanh Bao Nguyen Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 13830 Brookhurst St, Garden Grove, California |
| Authorized Official Name and Position | Khanh Bao Nguyen (PRESIDENT/CEO) |
| Authorized Official Contact | 7144674330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Khanh Bao Nguyen Md Inc 13830 Brookhurst St Garden Grove CA 92843-3121 Ph: (714) 467-4330 | Khanh Bao Nguyen Md Inc 13830 Brookhurst St Garden Grove CA 92843-3121 Ph: (714) 467-4330 |
| NPI Number | 1366756215 |
|---|---|
| Provider Enumeration Date | 08/03/2010 |
| Last Update Date | 04/10/2013 |
| Medicare PECOS PAC ID | 5294912531 |
|---|---|
| Medicare Enrollment ID | O20110614000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366756215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Khanh Bao Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548359474 PECOS PAC ID: 1850287319 Enrollment ID: I20040223001210 |
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