Organization
INTENSIVE CARE MEDICAL SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUC VAN NGUYEN M.D. (PRESIDENT)
(951) 278-5590
Entity
Organization
Contact information
Practice address
2975 SYCAMORE DR, SIMI VALLEY, CA 93065-1201
(951) 278-5590
(951) 272-9924
Mailing address
PO BOX 77790, CORONA, CA 92877-0126
(951) 278-5590
(951) 272-9924
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
CA
207RP1001X
Pulmonary Disease Physician
—
CA
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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