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Organization
TOM LE NGUYEN D.O. INC
Active
Organization
TOM LE NGUYEN D.O. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM L NGUYEN D.O. (PRESIDENT)
(760) 220-4575
Entity
Organization
Contact information
Practice address
625 E VALLEY BLVD, SUITE H & I, SAN GABRIEL, CA 91776-3591
(626) 572-4658
(626) 572-4336
Mailing address
625 E VALLEY BLVD, SUITE H & I, SAN GABRIEL, CA 91776-3591
(626) 572-4658
(626) 572-4336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A9384
MEDICAL LICENSE
CA
Enumeration date
08/11/2008
Last updated
08/11/2008
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