Individual
KHANH QUOC NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P
Contact information
Practice address
1801 E MARCH LN, STOCKTON, CA 95210-6629
(209) 954-3100
Mailing address
10609 WILLOW GLEN CIR, STOCKTON, CA 95209-4195
(209) 957-5083
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13374
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13374
NURSING LICENSE
CA
Enumeration date
07/25/2006
Last updated
03/07/2023
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