Nguyen, Bao Lou

Nguyen, Bao Lou is an individual health care provider with primary practice located at 2150 N Waterman Ave Ste 103, San Bernardino CA 92404-4811. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Nguyen, Bao Lou can be contacted via phone (909) 882-7974.

Contact Information

Primary practice address
2150 N Waterman Ave Ste 103 San Bernardino CA 92404-4811
Phone: (909) 882-7974
Fax: (909) 713-0192
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 42378 California

Profile Details

NPI number 1487768743
LBN Legal business name Nguyen, Bao Lou
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487768743 NPPES
California MEDICAID BN4237801

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