Organization
IM LOCUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN NGUYEN M.D. (SOLE OWNER)
(714) 230-5151
Entity
Organization
Contact information
Practice address
1025 S 2ND AVE, WALLA WALLA, WA 99362-4116
(702) 453-3799
(702) 453-5741
Mailing address
1516 E TROPICANA AVE STE 155, LAS VEGAS, NV 89119-8316
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60475120
WA
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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