Provider Demographics
NPI:1679503403
Name:NGUYEN, ANDY HUAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:HUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:HUAN
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:301 E SANTA CLARA ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95113-1939
Mailing Address - Country:US
Mailing Address - Phone:408-449-9351
Mailing Address - Fax:408-358-0711
Practice Address - Street 1:15000 LOS GATOS BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2017
Practice Address - Country:US
Practice Address - Phone:408-449-9351
Practice Address - Fax:408-358-0711
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor