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General NPI Number Information
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NPI Number | 1730906306
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Entity Type | Individual
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Provider Name | QUAN THAI NGUYEN
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Gender | Male
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 9191 WESTMINSTER AVE # 209
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City | GARDEN GROVE
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State | CA
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Zip | 92844-2751
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Country | US
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Telephone | 714-894-6600
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Fax | 714-583-6367
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Provider Business Mailing Address
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Address Line | 10335 LA DESPENSA AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5255
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Country | US
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Telephone | 714-766-2268
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 20169
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License Number State | CA
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