Provider Demographics
NPI:1861619009
Name:NGUYEN, TAI ANH (DC)
Entity type:Individual
Prefix:DR
First Name:TAI
Middle Name:ANH
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 1:9191 BOLSA AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5561
Mailing Address - Country:US
Mailing Address - Phone:714-891-0010
Mailing Address - Fax:714-891-0010
Practice Address - Street 1:9191 BOLSA AVE STE 203
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5561
Practice Address - Country:US
Practice Address - Phone:714-891-0010
Practice Address - Fax:714-891-0010
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26788111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor