Healthcare Provider Details

I. General information

NPI: 1528296571
Provider Name (Legal Business Name): ANTONI KIEN NGUYEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 09/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13382 GOLDENWEST ST STE 213
WESTMINSTER CA
92683-2247
US

IV. Provider business mailing address

13382 GOLDENWEST ST STE 213
WESTMINSTER CA
92683-2247
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-8484
  • Fax: 714-898-8484
Mailing address:
  • Phone: 714-898-8484
  • Fax: 714-898-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number28140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: