Provider Demographics
NPI:1376513937
Name:NGUYEN, TUAN DUY (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2463 ALVIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1611
Mailing Address - Country:US
Mailing Address - Phone:408-646-0703
Mailing Address - Fax:
Practice Address - Street 1:2463 ALVIN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1611
Practice Address - Country:US
Practice Address - Phone:408-646-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-29844111N00000X
CAAC 11953171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 29844OtherDOCTOR OF CHIROPRACTIC
CAAC 11953OtherLICENSED ACUPUNCTURIST
CADC 0298440Medicare PIN