Provider Demographics
NPI:1427326255
Name:NGUYEN, ANH D (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ANH
Middle Name:D
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 1:4201 DALE RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9767
Mailing Address - Country:US
Mailing Address - Phone:209-545-5687
Mailing Address - Fax:209-545-6709
Practice Address - Street 1:4201 DALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9767
Practice Address - Country:US
Practice Address - Phone:209-545-5687
Practice Address - Fax:209-545-6709
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA046268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA183500000XOtherPHARMACIST