Healthcare Provider Details

I. General information

NPI: 1316375330
Provider Name (Legal Business Name): DR. KATIE NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2013
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 E CARSON ST
LONG BEACH CA
90807-3044
US

IV. Provider business mailing address

2250 E CARSON ST
LONG BEACH CA
90807-3044
US

V. Phone/Fax

Practice location:
  • Phone: 562-490-0201
  • Fax:
Mailing address:
  • Phone: 562-490-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69529
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number69529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: