Individual
SI VAN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12601 GARDEN GROVE BLVD, PATHOLOGY DEPT., GARDEN GROVE, CA 92843-1908
(949) 874-0827
(310) 698-7054
Mailing address
20001 S RANCHO WAY, RANCHO DOMINGUEZ, CA 90220-6318
(310) 225-3244
(310) 698-7040
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A48904
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A489040
—
CA
Enumeration date
06/16/2006
Last updated
10/15/2024
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