Provider Demographics
NPI:1962587915
Name:NGUYEN, LINH DUY (LAC)
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E CALAVERAS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7708
Mailing Address - Country:US
Mailing Address - Phone:408-263-8816
Mailing Address - Fax:408-263-8817
Practice Address - Street 1:500 E CALAVERAS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7708
Practice Address - Country:US
Practice Address - Phone:408-263-8816
Practice Address - Fax:408-263-8817
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3109171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist