Provider Demographics
NPI:1285238329
Name:NHAN, DAT VI (RPH)
Entity type:Individual
Prefix:
First Name:DAT
Middle Name:VI
Last Name:NHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:DAT
Other - Middle Name:V
Other - Last Name:NHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:883 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083
Mailing Address - Country:US
Mailing Address - Phone:760-630-2134
Mailing Address - Fax:760-630-2965
Practice Address - Street 1:883 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083
Practice Address - Country:US
Practice Address - Phone:760-630-2134
Practice Address - Fax:760-630-2965
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist