Provider Demographics
NPI:1366615163
Name:NGUYEN, MYCHI THI (MD)
Entity type:Individual
Prefix:DR
First Name:MYCHI
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 E 18TH ST
Mailing Address - Street 2:2ND FLOOOR
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1729
Mailing Address - Country:US
Mailing Address - Phone:510-735-3888
Mailing Address - Fax:510-628-0568
Practice Address - Street 1:250 E 18TH ST
Practice Address - Street 2:2ND FLOOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1729
Practice Address - Country:US
Practice Address - Phone:510-735-3888
Practice Address - Fax:510-628-0568
Is Sole Proprietor?:No
Enumeration Date:2008-04-12
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA103314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine