Provider Demographics
NPI:1073583506
Name:NGUYEN, NHUNG NGHIEU (PHARMD)
Entity type:Individual
Prefix:MR
First Name:NHUNG
Middle Name:NGHIEU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 3RD AVE
Mailing Address - Street 2:#309
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3900
Mailing Address - Country:US
Mailing Address - Phone:619-200-6461
Mailing Address - Fax:
Practice Address - Street 1:2300 BOSWELL RD STE 190
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3535
Practice Address - Country:US
Practice Address - Phone:619-216-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist