Provider Demographics
NPI:1477675858
Name:NGUYEN, PAUL TRUONG (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:TRUONG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:TRUONG
Other - Middle Name:PAUL
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:18971 FLAGSTAFF LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-1931
Mailing Address - Country:US
Mailing Address - Phone:714-898-7235
Mailing Address - Fax:714-467-0008
Practice Address - Street 1:8907 WARNER AVE STE 250
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5083
Practice Address - Country:US
Practice Address - Phone:714-898-7235
Practice Address - Fax:714-467-0008
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19553111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFP860YMedicare PIN
CAU 16940Medicare UPIN