Provider Demographics
NPI:1427342385
Name:NGUYENBACH, ANNA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:NGUYENBACH
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 1:38019 47TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-3103
Mailing Address - Country:US
Mailing Address - Phone:661-998-2501
Mailing Address - Fax:661-998-2501
Practice Address - Street 1:38019 47TH ST E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-3103
Practice Address - Country:US
Practice Address - Phone:661-998-2501
Practice Address - Fax:661-998-2501
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist