Individual
DR. DAT Q NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12954 HAWTHORNE BLVD, SUITE 104, HAWTHORNE, CA 90250-4418
(310) 679-0269
(310) 679-1038
Mailing address
12954 HAWTHORNE BLVD, SUITE 104, HAWTHORNE, CA 90250-4418
(310) 679-0269
(310) 679-1038
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G77541
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G775410
—
CA
Enumeration date
07/28/2006
Last updated
12/21/2011
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