Provider Demographics
NPI:1922296177
Name:JOSEPH CHAU BAO NGUYEN, CHIROPRACTIC, CORP.
Entity Type:Organization
Organization Name:JOSEPH CHAU BAO NGUYEN, CHIROPRACTIC, CORP.
Other - Org Name:SOUTH COAST FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH CHAU
Authorized Official - Middle Name:BAO
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-210-2340
Mailing Address - Street 1:2901 W MACARTHUR BLVD
Mailing Address - Street 2:STE. 105
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6910
Mailing Address - Country:US
Mailing Address - Phone:714-210-2340
Mailing Address - Fax:
Practice Address - Street 1:2901 W MACARTHUR BLVD
Practice Address - Street 2:STE. 105
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6910
Practice Address - Country:US
Practice Address - Phone:714-210-2340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27689261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center