Individual
JENNIFER K NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1466 MARIPOSA STREET, SAN DIEGO, CA 92114-3612
(619) 777-9423
Mailing address
1466 MARIPOSA STREET, SAN DIEGO, CA 92114-3612
(619) 777-9423
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21671
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0062450
—
CA
Enumeration date
06/17/2011
Last updated
02/28/2014
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