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Organization
MIND SPACE MENTAL HEALTH INC
Active
Organization
MIND SPACE MENTAL HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES TUAN-TU SONG NGUYEN MD (DOCTOR/CEO)
(949) 689-9754
Entity
Organization
Contact information
Practice address
31852 COAST HWY STE 400, LAGUNA BEACH, CA 92651-6767
(949) 689-9754
Mailing address
31852 COAST HWY STE 400, LAGUNA BEACH, CA 92651-6767
(949) 689-9754
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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