Individual
KRISTINA THANH NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
(626) 962-4011
Mailing address
115 S SUNSET AVE, WEST COVINA, CA 91790
(626) 962-4011
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA64640
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/27/2022
Last updated
07/18/2024
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