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Individual

WENDY THU NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11942 PARAMOUNT BLVD, DOWNEY, CA 90242
(562) 923-6060
Mailing address
417 S STATE ST, LOS ANGELES, CA 90033-3818
(714) 640-3470
(714) 340-3475

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
363AM0700X
Medical Physician Assistant
Primary
55852
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55852
PHYSICIAN ASSISTANT BOARD
CA
Enumeration date
07/02/2015
Last updated
08/11/2018
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