Healthcare Provider Details

I. General information

NPI: 1801483763
Provider Name (Legal Business Name): GINA GIAU NGOC NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2020
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40657 ROAD 128
CUTLER CA
93615-2003
US

IV. Provider business mailing address

8551 BOYD AVE
GARDEN GROVE CA
92844-2504
US

V. Phone/Fax

Practice location:
  • Phone: 510-469-3400
  • Fax:
Mailing address:
  • Phone: 714-548-9582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number83957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: