MEDICARE: ANNIE 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	80022	CA

General Provider Information

NPI Number	:	1437797206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE NGUYEN

Provider Business Mailing Address
First Line	:	31575 DATE PALM DR
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-3138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	31575 DATE PALM DR
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-3138
Country	:	US
Telephone Number	:	760-324-4239
Fax Number	:

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

Provider Enumeration Date	:	12/12/2019
Last Update Date	:	12/12/2019

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Directions to “ ANNIE NGUYEN ” Practice Location

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