Provider Demographics
NPI:1750439139
Name:NGUYEN, ANTOINETTE A (DC)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:A
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10244 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4830
Mailing Address - Country:US
Mailing Address - Phone:714-537-1390
Mailing Address - Fax:
Practice Address - Street 1:10244 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4830
Practice Address - Country:US
Practice Address - Phone:714-537-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27136111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU82985Medicare UPIN