Individual
MR. ETHAN N NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2755 HERNDON AVE, CLOVIS, CA 93611-6800
(559) 324-4000
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A94286
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902072424
—
CA
Enumeration date
05/05/2008
Last updated
04/17/2014
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