Healthcare Provider Details

I. General information

NPI: 1831428937
Provider Name (Legal Business Name): PEI C VUONG CHIROPRACTOR A PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2009
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 S EUCLID AVE
PASADENA CA
91101-2717
US

IV. Provider business mailing address

233 S EUCLID AVE
PASADENA CA
91101-2717
US

V. Phone/Fax

Practice location:
  • Phone: 626-759-8006
  • Fax:
Mailing address:
  • Phone: 626-759-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12160
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC30448
License Number StateCA

VIII. Authorized Official

Name: DR. PEI C. VUONG
Title or Position: CLINIC DIRECTOR
Credential:
Phone: 626-759-8006