Im Locum LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD60475120 Issued in WA

Legal business name

IM LOCUM LLC

Practice address

1025 S 2ND Ave
Walla Walla, WA 99362-4116

Phone

(702) 453-3799

Fax

(702) 453-5741

NPI assigned

Aug 17, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Nguyen, M.D.

Title

Sole Owner

Phone

(714) 230-5151

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1053787747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 E TROPICANA AVE STE 155",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891198316",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 2ND AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624116",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IM LOCUM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "714-230-5151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60475120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.