Healthcare Provider Details

I. General information

NPI: 1164601480
Provider Name (Legal Business Name): DZU NGUYEN CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S PARK VICTORIA DR
MILPITAS CA
95035-5724
US

IV. Provider business mailing address

114 S PARK VICTORIA DR
MILPITAS CA
95035-5724
US

V. Phone/Fax

Practice location:
  • Phone: 408-719-1000
  • Fax: 408-719-0808
Mailing address:
  • Phone: 408-719-1000
  • Fax: 408-719-0808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC26909
License Number StateCA

VIII. Authorized Official

Name: DR. DZU NGUYEN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 408-719-1000