Individual
DEREK NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4435 BROCKTON AVE STE B, RIVERSIDE, CA 92501-4004
(951) 683-6830
(951) 228-9458
Mailing address
4435 BROCKTON AVE STE B, RIVERSIDE, CA 92501-4004
(951) 683-6830
(951) 228-9458
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A87744
CA
207R00000X
Internal Medicine Physician
Primary
A87744
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A877440
—
CA
Enumeration date
09/21/2005
Last updated
09/07/2022
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