Individual
BAC HAI NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
933 S SUNSET AVENUE, SUITE # 307, WEST COVINA, CA 91790
(626) 962-6811
(626) 960-9520
Mailing address
933 S SUNSET AVENUE, SUITE # 307, WEST COVINA, CA 91790
(626) 962-6811
(626) 960-9520
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G79012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G790120
—
CA
01
—
G79012
PTAN
CA
Enumeration date
08/29/2006
Last updated
07/17/2008
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