Provider Demographics
NPI:1639687304
Name:NGUYEN, TU HOANG (LAC)
Entity Type:Individual
Prefix:MR
First Name:TU
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6055 MERIDIAN AVE STE 30
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120
Mailing Address - Country:US
Mailing Address - Phone:408-766-1811
Mailing Address - Fax:408-550-7112
Practice Address - Street 1:6055 MERIDIAN AVE STE 30
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120
Practice Address - Country:US
Practice Address - Phone:408-766-1811
Practice Address - Fax:408-550-7112
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17411171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist