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General NPI Number Information
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NPI Number | 1396242582
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Entity Type | Organization
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Legal Business Name | TRITAN NGUYEN CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 18805 COX AVE STE 170
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City | SARATOGA
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State | CA
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Zip | 95070-4162
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Country | US
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Telephone | 408-364-6600
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Fax | 408-364-2041
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Provider Business Mailing Address
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Address Line | 18805 COX AVE STE 170
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City | SARATOGA
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State | CA
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Zip | 95070-4162
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Country | US
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Telephone | 408-364-6600
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Fax | 408-364-2041
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Authorized Official
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Title or Position | EXECUTIVE
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Name | DR. TAN TRI NGUYEN
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Credential | DC
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Telephone | 408-832-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC32378
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC32378
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License Number State | CA
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