Provider Demographics
NPI:1023645686
Name:NGUYEN, ANDY TIN (MD)
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:TIN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 WILSHIRE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2920
Mailing Address - Country:US
Mailing Address - Phone:310-855-7002
Mailing Address - Fax:
Practice Address - Street 1:8641 WILSHIRE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2920
Practice Address - Country:US
Practice Address - Phone:310-855-7002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA203374207RR0500X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No282N00000XHospitalsGeneral Acute Care Hospital