Provider Demographics
NPI:1144328303
Name:NGUYEN, CHUAN M (MD)
Entity type:Individual
Prefix:DR
First Name:CHUAN
Middle Name:M
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 1:710 N EUCLID ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4115
Mailing Address - Country:US
Mailing Address - Phone:714-991-8650
Mailing Address - Fax:714-517-2247
Practice Address - Street 1:710 N EUCLID ST
Practice Address - Street 2:SUITE 301
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4115
Practice Address - Country:US
Practice Address - Phone:714-991-8650
Practice Address - Fax:714-517-2247
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A634900Medicaid
CA00A634900Medicaid
BN5642233OtherDEA NUMBER