Provider Demographics
NPI:1356083927
Name:NGUYEN, TIFFANY THANH (MD, MS)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:THANH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:888 BREA CANYON RD STE 330
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91789-3095
Mailing Address - Country:US
Mailing Address - Phone:909-594-3382
Mailing Address - Fax:626-667-7633
Practice Address - Street 1:888 BREA CANYON RD STE 330
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789-3095
Practice Address - Country:US
Practice Address - Phone:909-594-3382
Practice Address - Fax:626-667-7633
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA188752208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics