Provider Demographics
NPI:1982777991
Name:NGUYEN, TOMMY (DC)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
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 1:2007 W HEDDING ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1428
Mailing Address - Country:US
Mailing Address - Phone:408-261-3811
Mailing Address - Fax:408-261-3811
Practice Address - Street 1:2007 W HEDDING ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1428
Practice Address - Country:US
Practice Address - Phone:408-261-3811
Practice Address - Fax:408-261-3811
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0278280Medicare ID - Type UnspecifiedCHIROPRACTIC