Provider Demographics
NPI:1912034075
Name:NGUYEN, AIDUY ALLEN (DC, OMD, PHD)
Entity Type:Individual
Prefix:DR
First Name:AIDUY
Middle Name:ALLEN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC, OMD, PHD
Other - Prefix:DR
Other - First Name:AI
Other - Middle Name:DUY
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, OMD, PHD
Mailing Address - Street 1:12526 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2166
Mailing Address - Country:US
Mailing Address - Phone:714-554-1111
Mailing Address - Fax:714-554-7777
Practice Address - Street 1:12526 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2166
Practice Address - Country:US
Practice Address - Phone:714-554-1111
Practice Address - Fax:714-554-7777
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor