Provider Demographics
NPI:1588392815
Name:NGUYEN, VICTOR (PHARMD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6376 JOSHUAVILLE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-7604
Mailing Address - Country:US
Mailing Address - Phone:714-204-7136
Mailing Address - Fax:
Practice Address - Street 1:801 S PAVILION CENTER DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-4566
Practice Address - Country:US
Practice Address - Phone:702-352-2055
Practice Address - Fax:702-352-2071
Is Sole Proprietor?:No
Enumeration Date:2022-08-14
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist