Individual
AI VAN NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 S GRAND AVE, LOS ANGELES, CA 90015-3010
(213) 748-2411
Mailing address
1401 S GRAND AVE, LOS ANGELES, CA 90015-3010
(213) 748-2411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95015772
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95015772
NURSE PRACTITIONER
CA
Enumeration date
10/27/2020
Last updated
02/03/2021
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