Provider Demographics
NPI:1447362934
Name:NGUYEN, THUY TUONG (MD)
Entity type:Individual
Prefix:
First Name:THUY
Middle Name:TUONG
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 1:3132 W MARCH LN
Mailing Address - Street 2:SUITE 5
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2354
Mailing Address - Country:US
Mailing Address - Phone:209-475-5500
Mailing Address - Fax:
Practice Address - Street 1:3132 W MARCH LN
Practice Address - Street 2:SUITE 5
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-2354
Practice Address - Country:US
Practice Address - Phone:209-475-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93782208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A937820Medicaid
CA00A937820Medicare PIN