Individual
IVY PHUONG NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1001 POTRERO AVENUE, BLDG. 5, 1ST FL, SAN FRANCISCO, CA 94110
(628) 206-8020
Mailing address
PO BOX 743749, LOS ANGELES, CA 90074-3749
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21211
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
07/10/2023
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