MEDICARE: DR. QUANG THIEN NGUYEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	58144	CA

General Provider Information

NPI Number	:	1205127123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUANG THIEN NGUYEN

Provider Business Mailing Address
First Line	:	20250 US HIGHWAY 18
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-2937
Country	:	US
Telephone Number	:	760-946-1174
Fax Number	:	760-242-1327

Provider Business Practice Location Address
First Line	:	20250 US HIGHWAY 18
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-2937
Country	:	US
Telephone Number	:	760-946-1174
Fax Number	:	760-242-1327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2011
Last Update Date	:	04/26/2011

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Directions to “ DR. QUANG THIEN NGUYEN ” Practice Location

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