Healthcare Provider Details

I. General information

NPI: 1487027546
Provider Name (Legal Business Name): ALEXANDRA VY NGUYEN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 11/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 W ALLUVIAL AVE STE 101
FRESNO CA
93711-5509
US

IV. Provider business mailing address

8411 SAN SIMEON CIR
BUENA PARK CA
90620-3032
US

V. Phone/Fax

Practice location:
  • Phone: 323-630-3250
  • Fax:
Mailing address:
  • Phone: 714-883-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number73752
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: