Provider Demographics
NPI:1508439704
Name:TAN NGOC NGUYEN CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:TAN NGOC NGUYEN CHIROPRACTIC, INC.
Other - Org Name:ALLIANCE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAN
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-636-1744
Mailing Address - Street 1:10961 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4929
Mailing Address - Country:US
Mailing Address - Phone:714-636-1744
Mailing Address - Fax:
Practice Address - Street 1:10961 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4929
Practice Address - Country:US
Practice Address - Phone:714-636-1744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC29570OtherCHIROPRACTIC