MEDICARE: BRIAN 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	68894	CA

General Provider Information

NPI Number	:	1518624550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN NGUYEN

Provider Business Mailing Address
First Line	:	391 DOS CABAZOS
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92029-7952
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	39872 LOS ALAMOS RD STE A10
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-5871
Country	:	US
Telephone Number	:	951-677-1114
Fax Number	:

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

Provider Enumeration Date	:	11/24/2021
Last Update Date	:	11/24/2021

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Directions to “ BRIAN NGUYEN ” Practice Location

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