Provider Demographics
NPI:1861406886
Name:NGUYEN, TUAN DUC (MD)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:DUC
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 1:3830 BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1702
Mailing Address - Country:US
Mailing Address - Phone:661-472-5003
Mailing Address - Fax:
Practice Address - Street 1:3830 BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1702
Practice Address - Country:US
Practice Address - Phone:661-472-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84883207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A848830Medicaid
CAI59312Medicare UPIN
CA00A848831Medicare PIN
CA00A848830Medicare PIN