Healthcare Provider Details

I. General information

NPI: 1508404443
Provider Name (Legal Business Name): NGUYEN V DAO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13181 PEYTON DR
CHINO HILLS CA
91709-6002
US

IV. Provider business mailing address

6864 FINCH CT
CHINO CA
91710-6287
US

V. Phone/Fax

Practice location:
  • Phone: 909-627-5099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69267
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: