=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437220589
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TUAN MINH NGUYEN L.AC.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2006
-----------------------------------------------------
Last Update Date | 02/11/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10725 INTERNATIONAL DR SUITE 110
-----------------------------------------------------
City | RANCHO CORDOVA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95670-7967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-631-2370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10725 INTERNATIONAL DR STE 110
-----------------------------------------------------
City | RANCHO CORDOVA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95670-7967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-631-2370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC4706
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------