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General NPI Number Information
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NPI Number | 1598332025
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Entity Type | Organization
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Legal Business Name | NGUYEN PROCARE CHIROPRACTIC INC
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 643 W 6TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90731-2523
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Country | US
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Telephone | 310-612-3975
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Fax |
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Provider Business Mailing Address
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Address Line | 16563 MOUNT SHERROD CIR
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-2341
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Country | US
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Telephone | 310-612-3975
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SON LAM NGUYEN
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Credential | D.C
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Telephone | 310-612-3975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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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 |
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License Number State |
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