Provider Demographics
NPI:1770714727
Name:LY, TUAN MINH (DC)
Entity type:Individual
Prefix:DR
First Name:TUAN
Middle Name:MINH
Last Name:LY
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 1:10800 PARAMOUNT BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3324
Mailing Address - Country:US
Mailing Address - Phone:562-862-2818
Mailing Address - Fax:562-862-2812
Practice Address - Street 1:10800 PARAMOUNT BLVD STE 306
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3324
Practice Address - Country:US
Practice Address - Phone:562-862-2818
Practice Address - Fax:562-862-2812
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-28698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor