Provider Demographics
NPI:1265695076
Name:EAST WEST FAMILY CARE, PC
Entity type:Organization
Organization Name:EAST WEST FAMILY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-361-6713
Mailing Address - Street 1:1001 CAPITAL FUNDS CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3937
Mailing Address - Country:US
Mailing Address - Phone:615-361-6713
Mailing Address - Fax:267-350-2118
Practice Address - Street 1:1001 CAPITAL FUNDS COURT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3937
Practice Address - Country:US
Practice Address - Phone:615-361-6713
Practice Address - Fax:267-350-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD40492173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1235164096OtherINDIVIDUAL NPI