Provider Demographics
NPI:1477998557
Name:NGUYEN, TAN TRI (DC)
Entity Type:Individual
Prefix:
First Name:TAN
Middle Name:TRI
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 1:18805 COX AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4162
Mailing Address - Country:US
Mailing Address - Phone:408-364-6600
Mailing Address - Fax:408-364-2041
Practice Address - Street 1:18805 COX AVE STE 170
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4162
Practice Address - Country:US
Practice Address - Phone:408-364-6600
Practice Address - Fax:408-364-2041
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC32378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor