Provider Demographics
NPI:1407136336
Name:NGUYEN, HOAN DUC (DC)
Entity Type:Individual
Prefix:DR
First Name:HOAN
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2791 GREEN RIVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-7452
Mailing Address - Country:US
Mailing Address - Phone:951-734-7692
Mailing Address - Fax:
Practice Address - Street 1:2791 GREEN RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-7452
Practice Address - Country:US
Practice Address - Phone:951-734-7692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor