Provider Demographics
NPI:1962807834
Name:NGUYEN, HOADON (PHARMD)
Entity type:Individual
Prefix:
First Name:HOADON
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 1:75060 GERALD FORD DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-2080
Mailing Address - Country:US
Mailing Address - Phone:760-691-2000
Mailing Address - Fax:888-505-3006
Practice Address - Street 1:75060 GERALD FORD DR
Practice Address - Street 2:SUITE #2
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-2080
Practice Address - Country:US
Practice Address - Phone:760-691-2000
Practice Address - Fax:888-505-3006
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist