Individual
DR. KIM NGA NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2461 SANTA MONICA BLVD, STE 108, SANTA MONICA, CA 90404-2138
(866) 487-7621
(310) 388-3029
Mailing address
2461 SANTA MONICA BLVD, STE 108, SANTA MONICA, CA 90404-2138
(866) 487-7621
(310) 388-3029
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
200300269
NC
2085R0202X
Diagnostic Radiology Physician
Primary
MD417883
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020226630001
—
PA
05
—
2793240
—
OH
01
—
KN4219572
MEDICARE PTAN
OH
Enumeration date
05/19/2006
Last updated
08/06/2008
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