Provider Demographics
NPI:1962778670
Name:NGUYEN, HUY (PHARMD)
Entity type:Individual
Prefix:
First Name:HUY
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 1:12262 JANET ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-3822
Mailing Address - Country:US
Mailing Address - Phone:714-235-3364
Mailing Address - Fax:714-537-9766
Practice Address - Street 1:12262 JANET ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-3822
Practice Address - Country:US
Practice Address - Phone:714-235-3364
Practice Address - Fax:714-537-9766
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9097183500000X
CA49345183500000X
NV13125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist