Healthcare Provider Details

I. General information

NPI: 1972762532
Provider Name (Legal Business Name): LINDA THI NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2008
Last Update Date: 06/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W IMPERIAL HWY
BREA CA
92821-4818
US

IV. Provider business mailing address

13894 BLUE RIBBON LN
CORONA CA
92880-3034
US

V. Phone/Fax

Practice location:
  • Phone: 714-529-2176
  • Fax:
Mailing address:
  • Phone: 951-279-9361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 58849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: