Organization
TO BE PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAO NGUYEN M.D. (PRESIDENT/CEO)
(707) 321-8542
Entity
Organization
Contact information
Practice address
15215 NATIONAL AVE, STE 104, LOS GATOS, CA 95032-2425
(707) 321-8542
Mailing address
PO BOX 2266, CUPERTINO, CA 95015-2266
(707) 321-8542
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A76835
CA
Other
Enumeration date
04/22/2014
Last updated
08/19/2014
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