Provider Demographics
NPI:1528483195
Name:NGUYEN, BAOTRAN JANICE (DC)
Entity type:Individual
Prefix:
First Name:BAOTRAN
Middle Name:JANICE
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 1:1227 W VALLEY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-2438
Mailing Address - Country:US
Mailing Address - Phone:626-293-8619
Mailing Address - Fax:626-576-2339
Practice Address - Street 1:1227 W VALLEY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-2438
Practice Address - Country:US
Practice Address - Phone:626-293-8619
Practice Address - Fax:626-576-2339
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 25761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor