Healthcare Provider Details

I. General information

NPI: 1033013859
Provider Name (Legal Business Name): NAM PHUONG PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10691 WESTMINSTER AVE # 101
GARDEN GROVE CA
92843-4911
US

IV. Provider business mailing address

10691 WESTMINSTER AVE # 101
GARDEN GROVE CA
92843-4911
US

V. Phone/Fax

Practice location:
  • Phone: 714-591-5700
  • Fax: 714-591-5701
Mailing address:
  • Phone: 714-591-5700
  • Fax: 714-591-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAVID LE
Title or Position: PHARMACIST- IN-CHARGE
Credential: RPH
Phone: 714-591-5700