Provider Demographics
NPI:1558598094
Name:TUAN DUC NGUYEN DC, LLC
Entity Type:Organization
Organization Name:TUAN DUC NGUYEN DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-554-5304
Mailing Address - Street 1:13872 HARBOR BLVD # 1A
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4000
Mailing Address - Country:US
Mailing Address - Phone:714-554-5304
Mailing Address - Fax:714-554-6052
Practice Address - Street 1:13872 HARBOR BLVD # 1A
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4000
Practice Address - Country:US
Practice Address - Phone:714-554-5304
Practice Address - Fax:714-554-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty