Provider Demographics
NPI:1154754604
Name:NGUYEN, BICH HA T (DACM, LAC)
Entity type:Individual
Prefix:MS
First Name:BICH HA
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:T
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DAOM, LAC
Mailing Address - Street 1:11425 VIA PROMESA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-2328
Mailing Address - Country:US
Mailing Address - Phone:619-548-0007
Mailing Address - Fax:
Practice Address - Street 1:3405 KENYON ST STE 501A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5008
Practice Address - Country:US
Practice Address - Phone:619-548-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15921171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist