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General NPI Number Information
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NPI Number | 1053760272
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Entity Type | Organization
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Legal Business Name | NGUYEN CHIROPRACTIC WELLNESS CENTER, P.C.
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 2114 SENTER RD SUITE 23
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City | SAN JOSE
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State | CA
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Zip | 95112-2608
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Country | US
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Telephone | 408-998-5463
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Fax | 408-998-5464
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Provider Business Mailing Address
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Address Line | 2114 SENTER RD SUITE 23
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City | SAN JOSE
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State | CA
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Zip | 95112-2608
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Country | US
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Telephone | 408-998-5463
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Fax | 408-998-5464
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHAUNCE PHOENYX
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Credential | D.C.
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Telephone | 408-998-5463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | DC29774
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License Number State | CA
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