Healthcare Provider Details

I. General information

NPI: 1922245869
Provider Name (Legal Business Name): THIEU DANG CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9061 BOLSA AVE SUITE 100
WESTMINSTER CA
92683-5558
US

IV. Provider business mailing address

9061 BOLSA AVENUE SUITE 100
WESTMINSTER CA
92683-5558
US

V. Phone/Fax

Practice location:
  • Phone: 714-890-9066
  • Fax: 714-890-9076
Mailing address:
  • Phone: 714-890-9066
  • Fax: 714-890-9076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC23780
License Number StateCA

VIII. Authorized Official

Name: DR. THIEU HUY DANG
Title or Position: PRESIDENT
Credential: D.C., C.C.S.P.
Phone: 714-890-9066