Provider Demographics
NPI:1104241710
Name:NGUYEN, TU YEN (PHARMD)
Entity type:Individual
Prefix:
First Name:TU YEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22555 MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-5115
Mailing Address - Country:US
Mailing Address - Phone:510-538-7819
Mailing Address - Fax:510-538-7923
Practice Address - Street 1:22555 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541
Practice Address - Country:US
Practice Address - Phone:510-538-7819
Practice Address - Fax:510-538-7923
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist