Individual
PHUONG L NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 877-5199
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1118
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245487693
—
NV
01
—
P00892335
RAILROAD MEDICARE
NV
Enumeration date
08/27/2008
Last updated
03/08/2024
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