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Individual

DEAN X NGHIEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3130 S HARBOR BLVD, 250, SANTA ANA, CA 92704-6824
(714) 619-8777
Mailing address
9403 EL BLANCO AVE, FOUNTAIN VALLEY, CA 92708-4511
(714) 287-8195

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17385
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA17385
MEDICAL LICENSE
CA
Enumeration date
10/23/2006
Last updated
10/17/2008
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