Healthcare Provider Details

I. General information

NPI: 1386944452
Provider Name (Legal Business Name): DUC V NGUYEN PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2010
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 WALERGA RD
ANTELOPE CA
95843-5722
US

IV. Provider business mailing address

7901 WALERGA RD
ANTELOPE CA
95843-5722
US

V. Phone/Fax

Practice location:
  • Phone: 916-725-6940
  • Fax: 916-725-9083
Mailing address:
  • Phone: 916-725-6940
  • Fax: 916-725-9083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: