Provider Demographics
NPI:1952680746
Name:NGUYEN, BAO C (DC)
Entity Type:Individual
Prefix:
First Name:BAO
Middle Name:C
Last Name:NGUYEN
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 1:2760 E SPRING ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2253
Mailing Address - Country:US
Mailing Address - Phone:562-424-1200
Mailing Address - Fax:562-424-1214
Practice Address - Street 1:2760 E SPRING ST
Practice Address - Street 2:SUITE 150
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2253
Practice Address - Country:US
Practice Address - Phone:562-424-1200
Practice Address - Fax:562-424-1214
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor