Healthcare Provider Details

I. General information

NPI: 1750275822
Provider Name (Legal Business Name): THUY TIEN VU NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE
LONG BEACH CA
90806-1701
US

IV. Provider business mailing address

812 E FLORENCE AVE
WEST COVINA CA
91790-5201
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number82672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: