Provider Demographics
NPI:1689805327
Name:QUAN, VINCENT W (DC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:W
Last Name:QUAN
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:PO BOX 28166
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0138
Mailing Address - Country:US
Mailing Address - Phone:714-835-2225
Mailing Address - Fax:714-569-0463
Practice Address - Street 1:1111 W TOWN AND COUNTRY RD
Practice Address - Street 2:SUITE 6
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4615
Practice Address - Country:US
Practice Address - Phone:714-835-2225
Practice Address - Fax:714-569-0463
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22782111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation