Provider Demographics
NPI:1922185586
Name:NGUYEN, LYNDA (MD)
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2550 S PARKER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1622
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO74305263OtherMEDICAID GROUP NUMBER
COC810776OtherMEDICARE GROUP NUMBER
WY1922185586Medicaid
CO020591OtherKAISER COMMERCIAL NUMBER
CO31458262OtherMEDICAID GROUP NUMBER
CO74409859Medicaid
CO348308OtherMEDICARE GROUP NUMBER
TX200698301Medicaid
CO020591OtherKAISER COMMERCIAL NUMBER
COC810776OtherMEDICARE GROUP NUMBER
CO74409859Medicaid
COP00624697Medicare PIN