Provider Demographics
NPI:1679564561
Name:NGUYEN-MINH, NHAT CANH (MD)
Entity type:Individual
Prefix:
First Name:NHAT
Middle Name:CANH
Last Name:NGUYEN-MINH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CANH-NHAT
Other - Middle Name:MINH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:71943 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4848
Mailing Address - Country:US
Mailing Address - Phone:760-776-7600
Mailing Address - Fax:760-776-7640
Practice Address - Street 1:71943 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:760-776-7600
Practice Address - Fax:760-776-7640
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53124208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery