Healthcare Provider Details
I. General information
NPI: 1003700378
Provider Name (Legal Business Name): DUNG THINGOC NGUYEN PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/03/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3901 LONE TREE WAY
ANTIOCH CA
94509
US
IV. Provider business mailing address
2213 TRINITY DRIVE
BRENTWOOD CA
94513
US
V. Phone/Fax
- Phone: 925-779-7200
- Fax: 925-779-7227
- Phone: 408-807-8690
- Fax: 925-779-7227
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 60108 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: