Individual
DR. BAO THAI NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 PIER AVE, SUITE #1, HERMOSA BEACH, CA 90254-3839
(424) 488-0500
(424) 488-0498
Mailing address
555 PIER AVE, SUITE #1, HERMOSA BEACH, CA 90254-3839
(424) 488-0500
(424) 488-0498
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
252803-2
NY
208100000X
Physical Medicine & Rehabilitation Physician
A95636
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194913756
NPI
CA
Enumeration date
10/09/2007
Last updated
02/10/2015
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