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NPI Code Detail

MEDICARE: KHANH BAO NGUYEN PHARMD

MEDICARE: KHANH BAO NGUYEN PHARMD
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
1183500000XPharmacist72288CA

General Provider Information

NPI Number : 1346632023
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHANH BAO NGUYEN PHARMD
Provider Business Mailing Address
First Line : 1330 E 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-8500
Country : US
Telephone Number : 714-547-1042
Fax Number :
Provider Business Practice Location Address
First Line : 1330 E 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-8500
Country : US
Telephone Number : 714-547-1042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2015
Last Update Date : 10/09/2020

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Directions to “ KHANH BAO NGUYEN PHARMD” Practice Location

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