MEDICARE: HAN TIEN VU D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC29356	CA

General Provider Information

NPI Number	:	1194977728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAN TIEN VU D.C.

Provider Business Mailing Address
First Line	:	8895 WESTMINSTER AVE
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92844-2608
Country	:	US
Telephone Number	:	714-890-7170
Fax Number	:	714-891-7176

Provider Business Practice Location Address
First Line	:	8895 WESTMINSTER AVE
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92844-2608
Country	:	US
Telephone Number	:	714-890-7170
Fax Number	:	714-891-7176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2008
Last Update Date	:	10/14/2008

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