Provider Demographics
NPI:1639206741
Name:NGUYEN, ANTHONY QUANG-TRUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:QUANG-TRUNG
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 1:1324 W COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-2724
Mailing Address - Country:US
Mailing Address - Phone:714-446-0200
Mailing Address - Fax:714-446-0200
Practice Address - Street 1:1324 W. COMMONWEALTH AVE.
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-2724
Practice Address - Country:US
Practice Address - Phone:714-446-0200
Practice Address - Fax:714-446-0200
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25360111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25360OtherBLUESHIELD OF CA
CADC25360OtherBLUESHIELD OF CA