Individual
DR. KEVIN KHAI TUAN TIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16543 BROOKHURST ST, FOUNTAIN VALLEY, CA 92708-2343
(714) 418-9749
(714) 418-1047
Mailing address
16144 GALLATIN ST, FOUNTAIN VALLEY, CA 92708-1440
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A77268
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2012536
—
CA
Enumeration date
02/23/2006
Last updated
05/30/2019
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