Healthcare Provider Details

I. General information

NPI: 1558087569
Provider Name (Legal Business Name): MINH QUYET NGUYEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARK NGUYEN PHARMD

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 BELL RD
AUBURN CA
95603-2502
US

IV. Provider business mailing address

2232 ARNOLD DR
ROCKLIN CA
95765-5902
US

V. Phone/Fax

Practice location:
  • Phone: 530-401-9979
  • Fax:
Mailing address:
  • Phone: 818-371-7278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number87064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: