Provider Demographics
NPI:1730343971
Name:ANNMARIE NGUYEN MD, INC
Entity type:Organization
Organization Name:ANNMARIE NGUYEN MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:TRANG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-539-5225
Mailing Address - Street 1:12665 GARDEN GROVE BLVD STE 611
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1920
Mailing Address - Country:US
Mailing Address - Phone:714-539-5225
Mailing Address - Fax:714-539-5213
Practice Address - Street 1:12665 GARDEN GROVE BLVD STE 611
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1920
Practice Address - Country:US
Practice Address - Phone:714-539-5225
Practice Address - Fax:714-539-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69150207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G691500Medicaid
CAG69150Medicare PIN
CAF60701Medicare UPIN