Provider Demographics
NPI:1386927937
Name:NGUYEN-HO, TIFFANY B (RPH)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:B
Last Name:NGUYEN-HO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15282 KNOLLWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2753
Mailing Address - Country:US
Mailing Address - Phone:714-892-7373
Mailing Address - Fax:
Practice Address - Street 1:3000 S BRISTOL ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6707
Practice Address - Country:US
Practice Address - Phone:714-427-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist