Provider Demographics
NPI:1104948652
Name:NGUYEN, DUNG THU (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:DUNG
Middle Name:THU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:KATHY
Other - Middle Name:THU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:15342 MONTPELLIER AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3130
Mailing Address - Country:US
Mailing Address - Phone:714-323-3864
Mailing Address - Fax:
Practice Address - Street 1:15990 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1014
Practice Address - Country:US
Practice Address - Phone:714-775-3974
Practice Address - Fax:714-775-3980
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH54956183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist