MEDICARE: DR. DICK DUY NGUYEN PHARMD, BCPS

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	73568	CA
2	1835P1200X	Pharmacotherapy Pharmacist	73568	CA
3	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	73568	CA

General Provider Information

NPI Number	:	1598134777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DICK DUY NGUYEN PHARMD, BCPS

Provider Business Mailing Address
First Line	:	5172 DEL SOL CIR
Second Line	:
City	:	LA PALMA
State	:	CA
Zip	:	90623-2210
Country	:	US
Telephone Number	:	714-642-6603
Fax Number	:

Provider Business Practice Location Address
First Line	:	23701 MAIN ST
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-5745
Country	:	US
Telephone Number	:	714-642-6603
Fax Number	:

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

Provider Enumeration Date	:	09/17/2015
Last Update Date	:	03/04/2022

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