Provider Demographics
NPI:1124301171
Name:NGUYEN, THUY P (PHARMD)
Entity type:Individual
Prefix:MS
First Name:THUY
Middle Name:P
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 1:1071 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-3744
Mailing Address - Country:US
Mailing Address - Phone:209-825-5481
Mailing Address - Fax:209-825-6998
Practice Address - Street 1:1071 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-3744
Practice Address - Country:US
Practice Address - Phone:209-825-5481
Practice Address - Fax:209-825-6998
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist