Provider Demographics
NPI:1770605115
Name:TRUONG P NGUYEN CHIROPRACTIC INC
Entity type:Organization
Organization Name:TRUONG P NGUYEN CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:TRUONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-898-7235
Mailing Address - Street 1:18971 FLAGSTAFF LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-1931
Mailing Address - Country:US
Mailing Address - Phone:714-898-7235
Mailing Address - Fax:714-467-0008
Practice Address - Street 1:8907 WARNER AVE STE 250
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5083
Practice Address - Country:US
Practice Address - Phone:714-898-7235
Practice Address - Fax:714-467-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19553111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFX759AMedicare PIN