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General NPI Number Information
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NPI Number | 1285024307
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH AND WELLNESS CLINIC
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 6005 FLORIN RD STE 300
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City | SACRAMENTO
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State | CA
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Zip | 95823-2487
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Country | US
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Telephone | 916-583-2632
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Fax | 866-236-0004
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Provider Business Mailing Address
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Address Line | 6005 FLORIN RD STE 300
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City | SACRAMENTO
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State | CA
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Zip | 95823-2487
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Country | US
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Telephone | 916-583-2632
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Fax | 866-236-0004
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENNIS S NGUYEN
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Credential | DC, PHD
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Telephone | 916-583-2632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 24184
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 24184
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 24184
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 24184
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License Number State | CA
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