Provider Demographics
NPI:1124468004
Name:NGUYEN CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:NGUYEN CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THE
Authorized Official - Middle Name:D
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-395-5804
Mailing Address - Street 1:1122 CORPORATE WAY SUITE 300
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831
Mailing Address - Country:US
Mailing Address - Phone:916-395-5804
Mailing Address - Fax:916-550-9831
Practice Address - Street 1:1122 CORPORATE WAY SUITE 300
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831
Practice Address - Country:US
Practice Address - Phone:916-395-5804
Practice Address - Fax:916-550-9831
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NGUYEN CHIROPRACTIC CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-25
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC32111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty