Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 21758 | CA |
Y | 213EP1101X | Primary Podiatric Medicine | E4494 | CA |
NPI | 1245495498 |
---|---|
Provider Name | Dr. Duc Tien Nguyen |
First Address | Westminster, CA 92683-5347 |
Second Address | Garden Grove, CA 92841-2536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2008 |
Last Update Date | 31/08/2016 |