Provider Demographics
NPI:1255436515
Name:NGUYENTU, TIM (DC)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:
Last Name:NGUYENTU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6937 LINDA VISTA RD
Mailing Address - Street 2:STE E
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6366
Mailing Address - Country:US
Mailing Address - Phone:858-274-8888
Mailing Address - Fax:858-220-7526
Practice Address - Street 1:6937 LINDA VISTA RD
Practice Address - Street 2:STE E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6366
Practice Address - Country:US
Practice Address - Phone:858-274-8888
Practice Address - Fax:858-220-7526
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC13886171100000X
CADC 29987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist