Healthcare Provider Details

I. General information

NPI: 1477020311
Provider Name (Legal Business Name): ANNA NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12736 BEACH BLVD APT 552
STANTON CA
90680-4098
US

IV. Provider business mailing address

12736 BEACH BLVD APT 552
STANTON CA
90680-4098
US

V. Phone/Fax

Practice location:
  • Phone: 714-726-7969
  • Fax:
Mailing address:
  • Phone: 714-726-7969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC36784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: