Individual
KAITLYN PHUONG NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
17220 NEWHOPE ST, #125, FOUNTAIN VALLEY, CA 92708-4272
(714) 435-0600
Mailing address
17220 NEWHOPE ST, #125, FOUNTAIN VALLEY, CA 92708-4272
(714) 435-0600
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21641
CA
Other
Enumeration date
08/18/2011
Last updated
05/03/2012
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