Individual
PHONG KY NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
350 TERRACINA BLVD, REDLANDS, CA 92373-4850
(909) 335-5500
Mailing address
2100 POWELL ST, STE 900, EMERYVILLE, CA 94608-1826
(510) 350-2600
(510) 879-9100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A51595
CA
208D00000X
General Practice Physician
Primary
A51595
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A515950
—
CA
Enumeration date
08/22/2006
Last updated
09/06/2023
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