Healthcare Provider Details

I. General information

NPI: 1457629768
Provider Name (Legal Business Name): VIET-HUONG VU NGUYEN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2011
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD DEPARTMENT OF NEUROLOGY
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

11301 WILSHIRE BLVD DEPARTMENT OF NEUROLOGY
LOS ANGELES CA
90073-1003
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3595
  • Fax: 310-268-4611
Mailing address:
  • Phone: 310-268-3595
  • Fax: 310-268-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number60627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: